Healthcare Provider Details

I. General information

NPI: 1023224094
Provider Name (Legal Business Name): WENDY KAY SNYDER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 MAPLE AVE W SUITE 7
VIENNA VA
22180-4240
US

IV. Provider business mailing address

1601 N HOWARD ST
ALEXANDRIA VA
22304-1021
US

V. Phone/Fax

Practice location:
  • Phone: 703-281-9313
  • Fax:
Mailing address:
  • Phone: 703-823-1159
  • Fax: 703-823-5677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0717000632
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: