Provider Demographics
NPI:1467573782
Name:SNYDER, JENNIFER ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:615 NANTAHALA DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7110
Mailing Address - Country:US
Mailing Address - Phone:919-806-0648
Mailing Address - Fax:919-575-7670
Practice Address - Street 1:ADULT ADMISSIONS UNIT, JOHN UMSTEAD HOSPITAL
Practice Address - Street 2:1003 12TH STREET
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-1626
Practice Address - Country:US
Practice Address - Phone:919-575-2444
Practice Address - Fax:919-575-7670
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2589103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical