Provider Demographics
NPI:1366863714
Name:SNYDER-LJUBISIC, TAMARA (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:SNYDER-LJUBISIC
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E PLANO PKWY
Mailing Address - Street 2:STE. 150
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6746
Mailing Address - Country:US
Mailing Address - Phone:214-952-2455
Mailing Address - Fax:
Practice Address - Street 1:801 E PLANO PKWY
Practice Address - Street 2:STE. 150
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6746
Practice Address - Country:US
Practice Address - Phone:214-952-2455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70338101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX70338OtherTX STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS