Provider Demographics
NPI:1962789099
Name:SNOW, SUZANNE TRIMBLE (MA LMHC)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:TRIMBLE
Last Name:SNOW
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 14TH AVE
Mailing Address - Street 2:COWLITZ COUNTY GUIDANCE ASSOCIATION
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632
Mailing Address - Country:US
Mailing Address - Phone:360-747-2515
Mailing Address - Fax:
Practice Address - Street 1:921 14TH AVE
Practice Address - Street 2:COWLITZ COUNTY GUIDANCE ASSOCIATION
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632
Practice Address - Country:US
Practice Address - Phone:360-747-2515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH#60126400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health