Healthcare Provider Details

I. General information

NPI: 1841728615
Provider Name (Legal Business Name): MELISSA BRUCE SNYDER LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 VILLAGE PKWY
HELENA AL
35080-4028
US

IV. Provider business mailing address

277 VILLAGE PKWY
HELENA AL
35080-4028
US

V. Phone/Fax

Practice location:
  • Phone: 205-624-3076
  • Fax: 844-835-1972
Mailing address:
  • Phone: 205-624-3076
  • Fax: 844-835-1972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3723
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: