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NPI Code Detail

MEDICARE: MELISSA ANN SNYDER LCSW

MEDICARE: MELISSA ANN SNYDER LCSW
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
1101YM0800XMental Health Counselor289013-3501UT

General Provider Information

NPI Number : 1841485760
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ANN SNYDER LCSW
Provider Business Mailing Address
First Line : 1390 S 1100 E STE 201
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-2463
Country : US
Telephone Number : 801-633-5173
Fax Number :
Provider Business Practice Location Address
First Line : 1390 S 1100 E STE 201
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-2463
Country : US
Telephone Number : 801-633-5173
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2007
Last Update Date : 08/11/2009

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