Provider Demographics
NPI:1184408932
Name:SNIDMAN, LEAH ROSE (STUDENT)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:ROSE
Last Name:SNIDMAN
Suffix:
Gender:F
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N 3RD ST APT 311
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64501-1795
Mailing Address - Country:US
Mailing Address - Phone:314-956-2930
Mailing Address - Fax:
Practice Address - Street 1:302 N 3RD ST APT 311
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64501-1795
Practice Address - Country:US
Practice Address - Phone:314-956-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program