Healthcare Provider Details

I. General information

NPI: 1831382100
Provider Name (Legal Business Name): KRISTEN GARRIGAN SNYDER-BRANNER LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 09/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N WASHINGTON ST SUITE 2470
HERKIMER NY
13350-1216
US

IV. Provider business mailing address

301 N WASHINGTON ST SUITE 2470
HERKIMER NY
13350-1216
US

V. Phone/Fax

Practice location:
  • Phone: 315-867-1465
  • Fax:
Mailing address:
  • Phone: 315-867-1465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0758031
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: