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Individual

MS. JENNY LOU SNOOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
840 E MAIN ST, PERHAM, MN 56573-1934
(218) 346-6100
(218) 346-6112
Mailing address
CANVAS HEALTH, 8451 E POINT DOUGLAS RD 5, COTTAGE GROVE, MN 55016
(651) 255-8558
(651) 458-5632

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303398
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
303398
LADC LICENSE
MN
Enumeration date
06/07/2014
Last updated
05/15/2020
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