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General NPI Number Information
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NPI Number | 1225465784
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Entity Type | Individual
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Provider Name | SELENA CAROLYN SNYDER MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/30/2013
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 1101 VINE ST
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City | SCRANTON
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State | PA
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Zip | 18510-2126
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Country | US
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Telephone | 570-344-6177
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Fax | 570-343-7457
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Provider Business Mailing Address
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Address Line | 93 BRIDGE ST APT #4
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City | TUNKHANNOCK
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State | PA
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Zip | 18657-1323
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Country | US
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Telephone | 813-541-1024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 15980
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OCO13793
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License Number State | PA
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