Provider Demographics
NPI:1457628331
Name:SNYDER, ALICE (LLP)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:VERBERKMOES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:376 E APPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-3466
Mailing Address - Country:US
Mailing Address - Phone:231-724-6050
Mailing Address - Fax:231-724-6066
Practice Address - Street 1:376 E APPLE AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-3466
Practice Address - Country:US
Practice Address - Phone:231-724-6050
Practice Address - Fax:231-724-6066
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009793103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical