Provider Demographics
NPI:1144771841
Name:SNYDER, AMY GRACE (MSW, HSV)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:GRACE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MSW, HSV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 INDEPENDENCE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078
Mailing Address - Country:US
Mailing Address - Phone:484-714-6969
Mailing Address - Fax:
Practice Address - Street 1:4210 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078-2580
Practice Address - Country:US
Practice Address - Phone:484-714-6969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW010445L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker