Provider Demographics
NPI:1164874988
Name:SNIDERMAN, EMILY BELLE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BELLE
Last Name:SNIDERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 SW TRENTON ST # 46956
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3747
Mailing Address - Country:US
Mailing Address - Phone:206-880-1686
Mailing Address - Fax:
Practice Address - Street 1:2721 SW TRENTON ST
Practice Address - Street 2:#46956
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126
Practice Address - Country:US
Practice Address - Phone:062-880-1686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WALH61062777101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program