Healthcare Provider Details

I. General information

NPI: 1942592274
Provider Name (Legal Business Name): NEELEY ANNE SNYDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 N CLASSEN BLVD STE 105
OKLAHOMA CITY OK
73118-2685
US

IV. Provider business mailing address

4001 N CLASSEN BLVD STE 105
OKLAHOMA CITY OK
73118-2685
US

V. Phone/Fax

Practice location:
  • Phone: 405-524-2424
  • Fax: 405-525-3677
Mailing address:
  • Phone: 405-524-2424
  • Fax: 405-525-3677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4643
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: