Healthcare Provider Details

I. General information

NPI: 1730993478
Provider Name (Legal Business Name): STEPHANIE SNIDER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 CHERRY AVE
CHARLOTTESVILLE VA
22903-3704
US

IV. Provider business mailing address

1645 CHERRY AVE
CHARLOTTESVILLE VA
22903-3704
US

V. Phone/Fax

Practice location:
  • Phone: 434-245-2654
  • Fax:
Mailing address:
  • Phone: 434-245-2654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: