MEDICARE: DR. DONNA SNIDER ARENDSHORST PH.D.

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	103T00000X	Psychologist	1014	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0344F	OTHER	NC	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1215915475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONNA SNIDER ARENDSHORST PH.D.

Provider Business Mailing Address
First Line	:	1829 E FRANKLIN ST
Second Line	:	SUITE 200-C
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-5861
Country	:	US
Telephone Number	:	919-933-4420
Fax Number	:	919-933-3835

Provider Business Practice Location Address
First Line	:	1829 E FRANKLIN ST
Second Line	:	SUITE 200-C
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-5861
Country	:	US
Telephone Number	:	919-933-4420
Fax Number	:	919-933-3835

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/08/2007

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