Provider Demographics
NPI:1023138070
Name:SNYDER, KARL D (MFT)
Entity type:Individual
Prefix:MR
First Name:KARL
Middle Name:D
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SUTTON WAY
Mailing Address - Street 2:CHILDREN'S MENTAL HEALTH
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-4144
Mailing Address - Country:US
Mailing Address - Phone:530-470-2736
Mailing Address - Fax:530-271-5943
Practice Address - Street 1:208 SUTTON WAY
Practice Address - Street 2:CHILDREN'S MENTAL HEALTH
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-4144
Practice Address - Country:US
Practice Address - Phone:530-470-2736
Practice Address - Fax:530-271-5943
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31057106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist