Provider Demographics
NPI:1821021882
Name:DENOIA, KAREN SUE SNYDER (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE SNYDER
Last Name:DENOIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 THREE CHIMNEYS LN
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6998
Mailing Address - Country:US
Mailing Address - Phone:770-777-8231
Mailing Address - Fax:770-777-8232
Practice Address - Street 1:2050 MARCONI DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5201
Practice Address - Country:US
Practice Address - Phone:770-777-2831
Practice Address - Fax:770-777-2832
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002613103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000980581AMedicaid
GA68BBGGBMedicare ID - Type Unspecified