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General NPI Number Information
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NPI Number | 1477060515
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Entity Type | Organization
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Legal Business Name | SNYDER PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 3423 NW EVANGELINE TRWY
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City | CARENCRO
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State | LA
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Zip | 70520-6241
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Country | US
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Telephone | 337-205-5855
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Fax | 337-245-0445
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Provider Business Mailing Address
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Address Line | PO BOX 82234
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City | LAFAYETTE
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State | LA
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Zip | 70598-2234
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ADDIE M SNYDER
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Credential | PMHNP
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Telephone | 985-226-0537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP09583
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License Number State | LA
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