Provider Demographics
NPI:1356640403
Name:SNYDER, BARBARA KAY (LADC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:KAY
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DIANE RD
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3626
Mailing Address - Country:US
Mailing Address - Phone:651-452-1321
Mailing Address - Fax:
Practice Address - Street 1:6043 HUDSON RD
Practice Address - Street 2:SUITE 290
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1018
Practice Address - Country:US
Practice Address - Phone:651-714-9437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN300801101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)