Provider Demographics
NPI:1104642990
Name:SNAVELY, EMMA ANN (MS, LCGC)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:ANN
Last Name:SNAVELY
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 SWEDE AVE APT 1201
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-4939
Mailing Address - Country:US
Mailing Address - Phone:319-457-0484
Mailing Address - Fax:
Practice Address - Street 1:PARDEE CANCER WELLNESS CENTER 4201 CAMPUS RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48670-0001
Practice Address - Country:US
Practice Address - Phone:989-794-0320
Practice Address - Fax:989-839-1458
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7201000587170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS