Healthcare Provider Details

I. General information

NPI: 1972669471
Provider Name (Legal Business Name): GREGORY S SNYDER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18021 OAK ST STE B
OMAHA NE
68130-6035
US

IV. Provider business mailing address

18021 OAK ST STE A
OMAHA NE
68130-6099
US

V. Phone/Fax

Practice location:
  • Phone: 402-986-6250
  • Fax: 402-702-1584
Mailing address:
  • Phone: 402-986-6250
  • Fax: 402-313-3174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number678
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number678
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: