Provider Demographics
NPI:1467776757
Name:SNYDER, JANE RICHARDSON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:RICHARDSON
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 VEST MILL RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2912
Mailing Address - Country:US
Mailing Address - Phone:336-659-6135
Mailing Address - Fax:336-659-6184
Practice Address - Street 1:3720 VEST MILL RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2912
Practice Address - Country:US
Practice Address - Phone:336-659-6135
Practice Address - Fax:336-659-6184
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0065511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical