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Individual

MRS. BETHANY SNOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
1780 E GRAND RIVER AVE, EAST LANSING, MI 48823-4998
(517) 980-0823
Mailing address
4655 DOBIE RD, STE 270, OKEMOS, MI 48864-6909
(517) 980-0823

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201005076
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30658
BCBSM
MI
01
64-00940
PHP
MI
Enumeration date
09/25/2006
Last updated
05/16/2016
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