Provider Demographics
NPI:1740611144
Name:SNYDER, ABIGAIL (RD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 OLDFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3777
Mailing Address - Country:US
Mailing Address - Phone:317-965-9275
Mailing Address - Fax:327-848-6373
Practice Address - Street 1:11315 OLDFIELD DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-3777
Practice Address - Country:US
Practice Address - Phone:317-965-9275
Practice Address - Fax:327-848-6373
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1108217133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered