Provider Demographics
NPI:1760281885
Name:SNOW, LILLIAN CAROL
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:CAROL
Last Name:SNOW
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 RICE ST NW
Mailing Address - Street 2:
Mailing Address - City:SLEEPY EYE
Mailing Address - State:MN
Mailing Address - Zip Code:56085-1341
Mailing Address - Country:US
Mailing Address - Phone:507-381-7869
Mailing Address - Fax:
Practice Address - Street 1:304 BELLE AVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5250
Practice Address - Country:US
Practice Address - Phone:877-909-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306987101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty