Provider Demographics
NPI:1679963961
Name:SNYDER, MALYNDA M (LPCC-SUPV)
Entity Type:Individual
Prefix:
First Name:MALYNDA
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LPCC-SUPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 COOK RD STE 400
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9600
Mailing Address - Country:US
Mailing Address - Phone:513-228-7800
Mailing Address - Fax:513-725-2231
Practice Address - Street 1:201 READING RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-398-2551
Practice Address - Fax:513-459-7300
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0501057-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health