Provider Demographics
NPI:1801254560
Name:SNOW, LYN ANN (BCBA LABA)
Entity type:Individual
Prefix:MS
First Name:LYN
Middle Name:ANN
Last Name:SNOW
Suffix:
Gender:F
Credentials:BCBA LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 STEDMAN ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2705
Mailing Address - Country:US
Mailing Address - Phone:978-735-4633
Mailing Address - Fax:
Practice Address - Street 1:229 STEDMAN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2705
Practice Address - Country:US
Practice Address - Phone:978-735-4633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA00123103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst