Provider Demographics
NPI:1043735855
Name:SNYDER, KRISTIN (LMHC, PMH-C)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LMHC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 N COLLEGE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-3599
Mailing Address - Country:US
Mailing Address - Phone:812-369-9793
Mailing Address - Fax:
Practice Address - Street 1:804 N COLLEGE AVE STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-3599
Practice Address - Country:US
Practice Address - Phone:812-369-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88000448A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health