Provider Demographics
NPI:1467855122
Name:SNYDER, EMILY WILLOUGHBY (ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:WILLOUGHBY
Last Name:SNYDER
Suffix:
Gender:F
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38B COTTAGE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6459
Mailing Address - Country:US
Mailing Address - Phone:207-423-3278
Mailing Address - Fax:
Practice Address - Street 1:38B COTTAGE GROVE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6459
Practice Address - Country:US
Practice Address - Phone:207-423-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104.01063682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer