Provider Demographics
NPI:1215561790
Name:SNYDER, BRIDGET (MA)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 INVERNESS WAY S STE 125
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5820
Mailing Address - Country:US
Mailing Address - Phone:719-354-2582
Mailing Address - Fax:719-428-4477
Practice Address - Street 1:304 INVERNESS WAY S STE 125
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5820
Practice Address - Country:US
Practice Address - Phone:719-354-2582
Practice Address - Fax:719-428-4477
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-19-39633103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst