MEDICARE: DARREN JAMES SNYDER LPC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1104952092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARREN JAMES SNYDER LPC

Provider Business Mailing Address
First Line	:	PO BOX 50184
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79159-0184
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 I-40 W STE 203
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-6000
Country	:	US
Telephone Number	:	806-584-8677
Fax Number	:

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/02/2009

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