Provider Demographics
NPI:1760847214
Name:SNIDER, HERNDON ADAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:HERNDON
Middle Name:ADAM
Last Name:SNIDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 E 32ND ST
Mailing Address - Street 2:SUITE 221
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4313
Mailing Address - Country:US
Mailing Address - Phone:417-623-1381
Mailing Address - Fax:417-623-0457
Practice Address - Street 1:2650 E 32ND ST
Practice Address - Street 2:SUITE 221
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4313
Practice Address - Country:US
Practice Address - Phone:417-623-1381
Practice Address - Fax:417-623-0457
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00653103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical