Provider Demographics
NPI:1982765970
Name:SNOW, ANITA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:LOUISE
Last Name:SNOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 CARONDELET STREET
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448
Mailing Address - Country:US
Mailing Address - Phone:225-634-0200
Mailing Address - Fax:225-634-0229
Practice Address - Street 1:4502 HIGHWAY 951
Practice Address - Street 2:EASTERN LA MENTAL HEALTH SYSTEM
Practice Address - City:JACKSON
Practice Address - State:LA
Practice Address - Zip Code:70748
Practice Address - Country:US
Practice Address - Phone:225-634-0224
Practice Address - Fax:225-634-0213
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD0227762084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
4E172Medicare ID - Type Unspecified
H59327Medicare UPIN