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General NPI Number Information
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NPI Number | 1740900869
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Entity Type | Individual
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Provider Name | CAITLYN SNYDER LPC-IT, SAC-IT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 115 5TH AVE S
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City | LA CROSSE
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State | WI
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Zip | 54601-9200
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Country | US
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Telephone | 262-229-9250
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Fax |
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Provider Business Mailing Address
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Address Line | 717 10TH ST N
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City | LA CROSSE
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State | WI
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Zip | 54601-3463
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Country | US
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Telephone | 507-460-8014
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 19576-130
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11035-125
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License Number State | WI
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