Provider Demographics
NPI:1346488830
Name:SNYDER, LIANA G (MFT)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:G
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11700 W CHARLESTON BLVD
Mailing Address - Street 2:#170-40
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1573
Mailing Address - Country:US
Mailing Address - Phone:702-808-8538
Mailing Address - Fax:
Practice Address - Street 1:3595 S TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-3019
Practice Address - Country:US
Practice Address - Phone:702-808-8538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMF01097101YM0800X
NV1204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1204OtherLADC
NVMF01097OtherMFT LICENSE
NV880503685OtherTAX ID