Provider Demographics
NPI:1376252247
Name:SNIDER, TAHLIA SABRINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAHLIA
Middle Name:SABRINA
Last Name:SNIDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 BENT WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-4147
Mailing Address - Country:US
Mailing Address - Phone:850-449-5007
Mailing Address - Fax:
Practice Address - Street 1:822 W PENSACOLA ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-8036
Practice Address - Country:US
Practice Address - Phone:850-449-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS65076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist