Healthcare Provider Details

I. General information

NPI: 1881151140
Provider Name (Legal Business Name): SARAH SLATER SNYDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42-135 OLD KALANIANAOLE RD
KAILUA HI
96734-5704
US

IV. Provider business mailing address

42-135 OLD KALANIANAOLE RD
KAILUA HI
96734-5704
US

V. Phone/Fax

Practice location:
  • Phone: 919-280-1572
  • Fax:
Mailing address:
  • Phone: 919-280-1572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4405
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: