MEDICARE: MISS GRETCHEN DARLENE SNYDER MSPC, LPC, NCC

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	101YP2500X	Professional Counselor	LPC-23783	AZ
2	2355S0801X	Speech-Language Assistant		AZ

General Provider Information

NPI Number	:	1457608457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS GRETCHEN DARLENE SNYDER MSPC, LPC, NCC

Provider Business Mailing Address
First Line	:	2415 E CAMELBACK RD STE 766
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4288
Country	:	US
Telephone Number	:	314-591-8960
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 E CAMELBACK RD STE 766
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4288
Country	:	US
Telephone Number	:	602-382-2060
Fax Number	:

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

Provider Enumeration Date	:	08/08/2012
Last Update Date	:	04/09/2025

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