Healthcare Provider Details

I. General information

NPI: 1205660438
Provider Name (Legal Business Name): ANGELLA D SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7223 W 95TH ST STE 220
OVERLAND PARK KS
66212-6195
US

IV. Provider business mailing address

7223 W 95TH ST STE 220
OVERLAND PARK KS
66212-6195
US

V. Phone/Fax

Practice location:
  • Phone: 913-346-1516
  • Fax:
Mailing address:
  • Phone: 913-346-1516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number03637-T
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: