Healthcare Provider Details

I. General information

NPI: 1417600966
Provider Name (Legal Business Name): LEAH ANNE SNYDER MOT, OTR/L, IMC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W CHESTER PIKE # 1B
HAVERTOWN PA
19083-5300
US

IV. Provider business mailing address

101 W CHESTER PIKE # 1B
HAVERTOWN PA
19083-5300
US

V. Phone/Fax

Practice location:
  • Phone: 610-449-3580
  • Fax:
Mailing address:
  • Phone: 610-449-3580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOC016673
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: