Basic Information
Provider Information
NPI: 1245611649
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNOW
FirstName: BARBARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW, LSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 165 E PARK AVE
Address2: P,O, BOX 683
City: NILES
State: OH
PostalCode: 444462352
CountryCode: US
TelephoneNumber: 3305448005
FaxNumber: 3305449379
Practice Location
Address1: 165 E PARK AVE
Address2:  
City: NILES
State: OH
PostalCode: 444462352
CountryCode: US
TelephoneNumber: 3305448005
FaxNumber: 3305449379
Other Information
ProviderEnumerationDate: 06/11/2015
LastUpdateDate: 06/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XS.1101186OHY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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