Healthcare Provider Details

I. General information

NPI: 1053322008
Provider Name (Legal Business Name): LAURIE EBERLE SNYDER L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OXFORD VLY SUITE 815
LANGHORNE PA
19047-1830
US

IV. Provider business mailing address

44 FOUNTAIN RD
LEVITTOWN PA
19056-1915
US

V. Phone/Fax

Practice location:
  • Phone: 215-750-6310
  • Fax:
Mailing address:
  • Phone: 267-994-3616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW013275
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: