Healthcare Provider Details

I. General information

NPI: 1144745290
Provider Name (Legal Business Name): ARIEL SNYDER LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 07/21/2022
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERKINS SQ
AKRON OH
44308-1063
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-5015
  • Fax: 330-543-3856
Mailing address:
  • Phone: 330-543-5015
  • Fax: 330-543-3856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1700345
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: