Healthcare Provider Details

I. General information

NPI: 1851827729
Provider Name (Legal Business Name): ALEXA BROOKE SNYDER M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 S UNIVERSITY DR SUITE 200B
DAVIE FL
33328-3808
US

IV. Provider business mailing address

10840 NW 13TH CT
CORAL SPRINGS FL
33071-8211
US

V. Phone/Fax

Practice location:
  • Phone: 954-895-0715
  • Fax:
Mailing address:
  • Phone: 954-895-0715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT3197
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: