Provider Demographics
NPI:1831954569
Name:SNELL, ILIA N (LPC)
Entity type:Individual
Prefix:
First Name:ILIA
Middle Name:N
Last Name:SNELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2431 E GLENN AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6504
Mailing Address - Country:US
Mailing Address - Phone:334-733-6841
Mailing Address - Fax:
Practice Address - Street 1:2431 E GLENN AVE STE 500
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6504
Practice Address - Country:US
Practice Address - Phone:334-733-6841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC05150101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional