Healthcare Provider Details

I. General information

NPI: 1801321286
Provider Name (Legal Business Name): ALIYAH SNYDER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 WESTWOOD PLZ
LOS ANGELES CA
90024-5055
US

IV. Provider business mailing address

4037 NW 13TH AVE
GAINESVILLE FL
32605-4610
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-4321
  • Fax:
Mailing address:
  • Phone: 850-582-2050
  • 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: