Healthcare Provider Details

I. General information

NPI: 1023210499
Provider Name (Legal Business Name): ROBERT J SNYDER III M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 SPRING ST
CHATTANOOGA TN
37405-3848
US

IV. Provider business mailing address

375 W 9TH ST APT B3W
COOKEVILLE TN
38501-6026
US

V. Phone/Fax

Practice location:
  • Phone: 423-756-2740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: