Provider Demographics
NPI:1548877533
Name:SNOW, ANNA NICOLE
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:NICOLE
Last Name:SNOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702A JOHNS HOPKINS DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7220
Mailing Address - Country:US
Mailing Address - Phone:252-550-2545
Mailing Address - Fax:
Practice Address - Street 1:702A JOHNS HOPKINS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7220
Practice Address - Country:US
Practice Address - Phone:757-619-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPENDING1041C0700X
NCC0158241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical