Healthcare Provider Details

I. General information

NPI: 1801295670
Provider Name (Legal Business Name): ELIZABETH SNYDER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 W 6TH ST
LOS ANGELES CA
90017-1833
US

IV. Provider business mailing address

2301 W LA HABRA BLVD APT 64
LA HABRA CA
90631-5067
US

V. Phone/Fax

Practice location:
  • Phone: 213-202-3970
  • Fax:
Mailing address:
  • Phone: 832-585-4301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: