Healthcare Provider Details

I. General information

NPI: 1104025295
Provider Name (Legal Business Name): SUZANNE M SNYDER MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 09/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4609 137TH ST SE
SNOHOMISH WA
98296-7655
US

IV. Provider business mailing address

4609 137TH ST SE
SNOHOMISH WA
98296-7655
US

V. Phone/Fax

Practice location:
  • Phone: 425-478-1644
  • Fax: 425-379-2650
Mailing address:
  • Phone: 425-478-1644
  • Fax: 425-379-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH 60145319
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: