MEDICARE: AGNIESZKA SNYDER BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-14-16148	CA

General Provider Information

NPI Number	:	1376958298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGNIESZKA SNYDER BCBA

Provider Business Mailing Address
First Line	:	9500 MICRON AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2617
Country	:	US
Telephone Number	:	916-402-3403
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 MICRON AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2617
Country	:	US
Telephone Number	:	916-402-3403
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	03/07/2016

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