Provider Demographics
NPI:1215485230
Name:SNOOK, TAMRA (LCSW)
Entity type:Individual
Prefix:
First Name:TAMRA
Middle Name:
Last Name:SNOOK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2422
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-2422
Mailing Address - Country:US
Mailing Address - Phone:407-955-7174
Mailing Address - Fax:850-660-6757
Practice Address - Street 1:156 N COUNTY HIGHWAY 393 UNIT 1
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459
Practice Address - Country:US
Practice Address - Phone:407-955-7174
Practice Address - Fax:850-660-6757
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW-138941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical