Provider Demographics
NPI:1447401484
Name:SNIDER, ROBIN LEE (LMT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:SNIDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3548
Mailing Address - Country:US
Mailing Address - Phone:304-673-5669
Mailing Address - Fax:
Practice Address - Street 1:134 ELM ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3548
Practice Address - Country:US
Practice Address - Phone:304-673-5669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2008-2411225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist