Healthcare Provider Details

I. General information

NPI: 1568767291
Provider Name (Legal Business Name): CATHERINE S SNYDER RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2011
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 PEACH ORCHARD RD
MC CONNELLSBURG PA
17233-8559
US

IV. Provider business mailing address

214 PEACH ORCHARD RD
MC CONNELLSBURG PA
17233-8559
US

V. Phone/Fax

Practice location:
  • Phone: 717-485-6166
  • Fax: 717-485-6133
Mailing address:
  • Phone: 717-485-6166
  • Fax: 717-485-6133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN001401
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: