Provider Demographics
NPI:1063170488
Name:SNOO-INK
Entity type:Organization
Organization Name:SNOO-INK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOEYINK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:616-970-3724
Mailing Address - Street 1:1295 68TH ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49508-7009
Mailing Address - Country:US
Mailing Address - Phone:616-803-9864
Mailing Address - Fax:
Practice Address - Street 1:1295 68TH ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-7009
Practice Address - Country:US
Practice Address - Phone:616-803-9864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty