Healthcare Provider Details

I. General information

NPI: 1346794781
Provider Name (Legal Business Name): JORDAN ALESSANDRA SNYDER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2016
Last Update Date: 10/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8405 CHURCH RANCH BLVD
WESTMINSTER CO
80021-3918
US

IV. Provider business mailing address

8405 CHURCH RANCH BLVD
WESTMINSTER CO
80021-3918
US

V. Phone/Fax

Practice location:
  • Phone: 303-438-2322
  • Fax:
Mailing address:
  • Phone: 303-438-2322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW.0009922203
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: