Healthcare Provider Details

I. General information

NPI: 1356127831
Provider Name (Legal Business Name): AMBER E. SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 HIDDEN VALLEY RD APT 2
NORTHFIELD MN
55057-3121
US

IV. Provider business mailing address

2220 HIDDEN VALLEY RD APT 2
NORTHFIELD MN
55057-3121
US

V. Phone/Fax

Practice location:
  • Phone: 952-492-9015
  • Fax:
Mailing address:
  • Phone: 952-492-9015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: