Healthcare Provider Details

I. General information

NPI: 1134441207
Provider Name (Legal Business Name): JEFFERY DANIEL SNARR PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 FOURTH SECTION RD STE 400
BROCKPORT NY
14420-2415
US

IV. Provider business mailing address

6565 FOURTH SECTION RD STE 400
BROCKPORT NY
14420-2415
US

V. Phone/Fax

Practice location:
  • Phone: 585-637-6740
  • Fax: 585-637-8096
Mailing address:
  • Phone: 585-637-6740
  • Fax: 585-637-8096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number017772
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: