Healthcare Provider Details

I. General information

NPI: 1770156028
Provider Name (Legal Business Name): DIANA R SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 GRAEME WAY
WARMINSTER PA
18974-1012
US

IV. Provider business mailing address

1517 GRAEME WAY
WARMINSTER PA
18974-1012
US

V. Phone/Fax

Practice location:
  • Phone: 267-269-0269
  • Fax:
Mailing address:
  • Phone: 267-269-0269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF000996
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: