MEDICARE: KATHERINE SNYDER LPC

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	101Y00000X	Counselor	178.014696	IL

General Provider Information

NPI Number	:	1740877729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE SNYDER LPC

Provider Business Mailing Address
First Line	:	3046 W ARMITAGE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5935
Country	:	US
Telephone Number	:	312-600-8042
Fax Number	:

Provider Business Practice Location Address
First Line	:	3046 W ARMITAGE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5935
Country	:	US
Telephone Number	:	312-600-8042
Fax Number	:

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

Provider Enumeration Date	:	12/24/2020
Last Update Date	:	12/24/2020

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