Provider Demographics
NPI:1417602772
Name:SNYDER, AMY D (RD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:D
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1786 RUNNING DEER DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:PA
Mailing Address - Zip Code:17922-9336
Mailing Address - Country:US
Mailing Address - Phone:570-617-6604
Mailing Address - Fax:
Practice Address - Street 1:1786 RUNNING DEER DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:PA
Practice Address - Zip Code:17922-9336
Practice Address - Country:US
Practice Address - Phone:570-617-6604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003800133V00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered