Individual
DR. ELLEN WILLIAMS SNIPES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10 CLARK ST, ENTERPRISE, FL 32725-8106
(386) 668-9407
Mailing address
10 CLARK ST, ENTERPRISE, FL 32725-8106
(386) 668-9407
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PY3865
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211234500
—
FL
01
—
73168
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
05/30/2008
Last updated
05/30/2008
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