Individual
MARK E. SNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
311 N. ALLUMBAUGH ST, BOISE, ID 83704-9208
(208) 375-6402
(208) 323-1850
Mailing address
311 N. ALLUMBAUGH ST, BOISE, ID 83704-9208
(208) 375-6402
(208) 323-1850
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-61
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015907
REGENCE BLUE SHIELD
ID
01
—
N0617
BLUE CROSS
ID
Enumeration date
01/22/2007
Last updated
12/30/2008
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