Healthcare Provider Details

I. General information

NPI: 1699483479
Provider Name (Legal Business Name): DIANE C SNYDER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 E BROADWAY
SALEM NY
12865-3100
US

IV. Provider business mailing address

1087 COUNTY ROUTE 30
SALEM NY
12865-1817
US

V. Phone/Fax

Practice location:
  • Phone: 412-670-2556
  • Fax:
Mailing address:
  • Phone: 412-670-2556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: