Healthcare Provider Details

I. General information

NPI: 1457628331
Provider Name (Legal Business Name): ALICE SNYDER LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICE VERBERKMOES

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 E APPLE AVE
MUSKEGON MI
49442-3466
US

IV. Provider business mailing address

376 E APPLE AVE
MUSKEGON MI
49442-3466
US

V. Phone/Fax

Practice location:
  • Phone: 231-724-6050
  • Fax: 231-724-6066
Mailing address:
  • Phone: 231-724-6050
  • Fax: 231-724-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301009793
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: