Provider Demographics
NPI:1659458719
Name:SNIPES, GRETA A (LISW)
Entity type:Individual
Prefix:MS
First Name:GRETA
Middle Name:A
Last Name:SNIPES
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 N LUDLOW ST
Mailing Address - Street 2:SUITE 1212
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1158
Mailing Address - Country:US
Mailing Address - Phone:937-222-5496
Mailing Address - Fax:
Practice Address - Street 1:131 N LUDLOW ST.
Practice Address - Street 2:SUITE 1212
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1158
Practice Address - Country:US
Practice Address - Phone:937-222-5496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00021371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical