Provider Demographics
NPI:1801863246
Name:SNYDER, RICARDO ANTHONY (LMFT)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:ANTHONY
Last Name:SNYDER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:RICK
Other - Middle Name:ANTHONY
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:85 DEBARRY AVE APT 3051
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-2363
Mailing Address - Country:US
Mailing Address - Phone:804-516-6683
Mailing Address - Fax:
Practice Address - Street 1:4375 US HIGHWAY 17 STE 103
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4832
Practice Address - Country:US
Practice Address - Phone:904-269-0886
Practice Address - Fax:904-269-0499
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4025106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA193559OtherBCBS