Healthcare Provider Details

I. General information

NPI: 1679763015
Provider Name (Legal Business Name): LINDA G SNYDER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13044 MARINE AVE
ST LOUIS MO
63146
US

IV. Provider business mailing address

13044 MARINE AVE
ST LOUIS MO
63146
US

V. Phone/Fax

Practice location:
  • Phone: 314-434-4535
  • Fax: 314-434-9157
Mailing address:
  • Phone: 314-434-4535
  • Fax: 314-434-9157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number002651
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: