Provider Demographics
NPI:1689798357
Name:PETREANU, MOLLY ANNE SNYDER (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:ANNE SNYDER
Last Name:PETREANU
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6760 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4909
Mailing Address - Country:US
Mailing Address - Phone:947-366-0749
Mailing Address - Fax:
Practice Address - Street 1:6760 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4909
Practice Address - Country:US
Practice Address - Phone:947-366-0749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04395235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist