Provider Demographics
NPI:1104025295
Name:SNYDER, SUZANNE M (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 137TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-7655
Mailing Address - Country:US
Mailing Address - Phone:425-478-1644
Mailing Address - Fax:425-379-2650
Practice Address - Street 1:4609 137TH ST SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-7655
Practice Address - Country:US
Practice Address - Phone:425-478-1644
Practice Address - Fax:425-379-2650
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60145319101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health