Healthcare Provider Details

I. General information

NPI: 1952777435
Provider Name (Legal Business Name): ANA M SNYDER L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5842 W MYRTLE AVE
GLENDALE AZ
85301-1875
US

IV. Provider business mailing address

3820 W EL CAMINO DR
PHOENIX AZ
85051-9124
US

V. Phone/Fax

Practice location:
  • Phone: 602-799-3336
  • Fax: 602-589-6212
Mailing address:
  • Phone: 602-799-3336
  • Fax: 602-589-6212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-00526P
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: