Provider Demographics
NPI:1134433428
Name:SNOW, DEBRA DIANE
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:DIANE
Last Name:SNOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CROSBY RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4370
Mailing Address - Country:US
Mailing Address - Phone:603-516-9300
Mailing Address - Fax:603-743-3244
Practice Address - Street 1:113 CROSBY RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4370
Practice Address - Country:US
Practice Address - Phone:603-516-9300
Practice Address - Fax:603-743-3244
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator