Provider Demographics
NPI:1881160422
Name:SNAY, ERICA KATE (LMT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:KATE
Last Name:SNAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:KATE
Other - Last Name:HINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:435 CHERRY ST SE STE B
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4672
Mailing Address - Country:US
Mailing Address - Phone:616-233-0960
Mailing Address - Fax:
Practice Address - Street 1:435 CHERRY ST SE STE B
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4672
Practice Address - Country:US
Practice Address - Phone:616-233-0960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501010165225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7501010165OtherSTATE OF MICHIGAN