Basic Information
| Provider Information | |||||||||
| NPI: | 1194398123 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNOW-FERRILL | ||||||||
| FirstName: | WILLOW | ||||||||
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| Credential: | LPC INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4273 HEAVENS WAY S | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973022793 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5037995452 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 HAWTHORNE AVE SE STE A130 | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973010074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5419004285 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2021 | ||||||||
| LastUpdateDate: | 07/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | R6818 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.