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Provider Information for 1598086480


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Dr. DAVID LOREN SNOWDEN LCSW


Sex: Male

NPI: 1598086480
Last Updated: 2021-04-21
Certification Date: 2021-03-29

Details

NameValue
NPI1598086480
Enumeration Date2010-06-15
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address HQ AFPC/DP2NP
550 C ST W STE 33
RANDOLPH AFB, TX 78154-4734
United States

Phone: 210-565-0686 | Fax:
 
Primary Practice Address 221 3RD ST W BLDG 1040
JBSA RANDOLPH, TX 78150-4800
United States

Phone: 210-565-0686 | Fax:
 
Secondary Practice Address(es)

307 BOATNER RD STE 114
EGLIN AFB, FL 32542
United States

Phone: 850-883-9501 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 104100000X - Social Worker IDLMSW 30531
Yes 1041C0700X - Social Worker - ClinicalIDLCSW32485