Provider Demographics
NPI:1114169521
Name:SNIDER, TRACY TURNER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:TURNER
Last Name:SNIDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 7TH ST
Mailing Address - Street 2:BUILDING 700/700-A
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098-2227
Mailing Address - Country:US
Mailing Address - Phone:478-327-8398
Mailing Address - Fax:478-327-8426
Practice Address - Street 1:655 7TH ST
Practice Address - Street 2:BUILDING 700/700-A
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098-2227
Practice Address - Country:US
Practice Address - Phone:478-327-8398
Practice Address - Fax:478-327-8426
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA34451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical