Healthcare Provider Details

I. General information

NPI: 1023138070
Provider Name (Legal Business Name): KARL D SNYDER M.F.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 SUTTON WAY CHILDREN'S MENTAL HEALTH
GRASS VALLEY CA
95945-4144
US

IV. Provider business mailing address

208 SUTTON WAY CHILDREN'S MENTAL HEALTH
GRASS VALLEY CA
95945-4144
US

V. Phone/Fax

Practice location:
  • Phone: 530-470-2736
  • Fax: 530-271-5943
Mailing address:
  • Phone: 530-470-2736
  • Fax: 530-271-5943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC31057
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: