Provider Demographics
NPI:1609150986
Name:SNYDER, EMILY SUSAN (LMT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SUSAN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 KARYL ST
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43566-1042
Mailing Address - Country:US
Mailing Address - Phone:419-787-8625
Mailing Address - Fax:419-878-0429
Practice Address - Street 1:2525 N REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-2089
Practice Address - Country:US
Practice Address - Phone:419-787-8625
Practice Address - Fax:419-878-0429
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.019860171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor