Healthcare Provider Details

I. General information

NPI: 1942378781
Provider Name (Legal Business Name): SHAWNA E.M. SNYDER D. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 06/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 AQUIDNECK AVE
MIDDLETOWN RI
02842-7600
US

IV. Provider business mailing address

170 AQUIDNECK AVE
MIDDLETOWN RI
02842-7600
US

V. Phone/Fax

Practice location:
  • Phone: 401-297-1642
  • Fax:
Mailing address:
  • Phone: 401-297-1642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberDA00325
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: