Provider Demographics
NPI:1013923531
Name:SNYDER, ANNABELLE CHU (LICSW)
Entity Type:Individual
Prefix:PROF
First Name:ANNABELLE
Middle Name:CHU
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WINGATE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4520
Mailing Address - Country:US
Mailing Address - Phone:781-863-0568
Mailing Address - Fax:781-863-0568
Practice Address - Street 1:10 MUZZEY ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5222
Practice Address - Country:US
Practice Address - Phone:781-799-0541
Practice Address - Fax:781-863-0568
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10273751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851420Medicaid
MAP20604Medicare UPIN
MA1851420Medicaid