Provider Demographics
NPI:1548420573
Name:SNIDER, GREGORY (LPC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:SNIDER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:GREG
Other - Middle Name:
Other - Last Name:SNIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 3903
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36903-1224
Mailing Address - Country:US
Mailing Address - Phone:334-328-9134
Mailing Address - Fax:
Practice Address - Street 1:4035 HWY 231
Practice Address - Street 2:SUITE G
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36093-1224
Practice Address - Country:US
Practice Address - Phone:334-328-9134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health