Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TH0004X | Health Psychologist |
NPI | 1326376153 |
---|---|
Provider Name | Dov A. Snow |
First Address | Far Rockaway, NY 11691-5636 |
Second Address | Far Rockaway, NY 11691-5636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2009 |
Last Update Date | 07/12/2009 |