Provider Demographics
NPI:1407190127
Name:SNYDER, ASHLEY MARIE (APSW, SACIT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:APSW, SACIT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:ROSENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5203 AUTUMN LEAF LANE
Mailing Address - Street 2:APT. 389
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704
Mailing Address - Country:US
Mailing Address - Phone:920-264-4769
Mailing Address - Fax:
Practice Address - Street 1:5203 AUTUMN LEAF LANE
Practice Address - Street 2:APT. 389
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704
Practice Address - Country:US
Practice Address - Phone:920-264-4769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI128778-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker