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General NPI Number Information
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NPI Number | 1699823294
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Entity Type | Individual
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Provider Name | JANE C SNYDER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1581 BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-4602
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Country | US
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Telephone | 617-232-8016
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Fax | 617-964-2106
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Provider Business Mailing Address
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Address Line | 40 HINCKLEY RD
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City | WABAN
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State | MA
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Zip | 02468-1724
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Country | US
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Telephone | 617-964-2106
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Fax | 617-964-2106
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3185
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License Number State | MA
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