Provider Demographics
NPI:1205036514
Name:DR MOLLY SNELL, PA
Entity Type:Organization
Organization Name:DR MOLLY SNELL, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-463-5430
Mailing Address - Street 1:1000 S FEDERAL HWY
Mailing Address - Street 2:#106
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1237
Mailing Address - Country:US
Mailing Address - Phone:954-463-5430
Mailing Address - Fax:954-463-1687
Practice Address - Street 1:1000 S FEDERAL HWY
Practice Address - Street 2:#106
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1237
Practice Address - Country:US
Practice Address - Phone:954-463-5430
Practice Address - Fax:954-463-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0002615103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty