| Doctor Name: | MS. KELLEY BERNICE SNOW |
| NPI Number: | 1245508944 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 6801089284 |
| Business Practice Address: | 1485 M 139 Benton Harbor, MI - 490225711 |
| Business Phone Number: | 2699250585 |
| Business Fax Number: | 2699271326 |
| Mailing Address: | 1485 M 139, BENTON HARBOR |
| State: | MI |
| Postal Code: | 490225711 |
| Phone Number: | 2699250585 |
| Fax Number: | 2699271326 |
| NPI Enumeration Date: | 12/08/2011 |
| NPI Last Update Date: | 12/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6801089284 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |