Healthcare Provider Details

I. General information

NPI: 1275592669
Provider Name (Legal Business Name): SUZANNE BUSBEE SNYDER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 RIVER DR
COLUMBIA SC
29201-1749
US

IV. Provider business mailing address

920 RICKENBAKER RD
COLUMBIA SC
29205-2152
US

V. Phone/Fax

Practice location:
  • Phone: 803-315-0532
  • Fax: 803-771-6685
Mailing address:
  • Phone: 803-234-7999
  • Fax: 803-771-6685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3927
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: