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General NPI Number Information
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NPI Number | 1588802300
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Entity Type | Individual
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Provider Name | DIANE LEE SNOVER LMT
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Gender | Female
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 324 E MAIN ST SUITE 202
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City | NEWARK
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State | DE
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Zip | 19711-7150
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Country | US
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Telephone | 302-521-9425
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Fax |
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Provider Business Mailing Address
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Address Line | 17050 RUST RD
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City | MILFORD
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State | DE
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Zip | 19963-3620
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Country | US
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Telephone | 302-265-2325
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MT0000508
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License Number State | DE
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