MEDICARE: MS. JAMIE MAXINE SNIDER MSSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	16054	TX

General Provider Information

NPI Number	:	1043476781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAMIE MAXINE SNIDER MSSW

Provider Business Mailing Address
First Line	:	1008 CARTER RD
Second Line	:
City	:	FORT BLISS
State	:	TX
Zip	:	79916-6709
Country	:	US
Telephone Number	:	915-569-8438
Fax Number	:	915-569-5712

Provider Business Practice Location Address
First Line	:	1008 CARTER RD
Second Line	:
City	:	FORT BLISS
State	:	TX
Zip	:	79916-6709
Country	:	US
Telephone Number	:	915-569-8438
Fax Number	:	915-569-5712

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	08/01/2008

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