Healthcare Provider Details

I. General information

NPI: 1861698896
Provider Name (Legal Business Name): JENNIFER SNYDER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 E MAIN ST
COLUMBUS OH
43205-2140
US

IV. Provider business mailing address

207 OVERTRICK DR
DELAWARE OH
43015-3403
US

V. Phone/Fax

Practice location:
  • Phone: 614-252-0731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0700662
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: