Healthcare Provider Details

I. General information

NPI: 1689964918
Provider Name (Legal Business Name): CRYSTAL SNYDER BA OF PSYCHOLOGY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 WEST AVE
MOUNT CARMEL PA
17851-1303
US

IV. Provider business mailing address

4111 MILLBROOK RD
MOUNT JOY PA
17552-9391
US

V. Phone/Fax

Practice location:
  • Phone: 570-339-4823
  • Fax:
Mailing address:
  • Phone: 717-587-3414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: