Provider Demographics
NPI:1376685362
Name:SNITCHLER, ERIC (PHD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SNITCHLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1163
Mailing Address - Street 2:1306 ANDREWS DRIVE
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68702-1163
Mailing Address - Country:US
Mailing Address - Phone:402-851-4026
Mailing Address - Fax:402-379-2487
Practice Address - Street 1:1306 ANDREWS DRIVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701
Practice Address - Country:US
Practice Address - Phone:402-851-4026
Practice Address - Fax:402-379-2487
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE629103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47084203426Medicaid
NE80007OtherBCBS PROVIDER #
NE248797OtherMIDLANDS CHOICE IND. #
NE248797OtherMIDLANDS CHOICE IND. #