Provider Demographics
NPI:1336883925
Name:SNYDER, TIANDRA LOUANN LEVIS
Entity Type:Individual
Prefix:
First Name:TIANDRA
Middle Name:LOUANN LEVIS
Last Name:SNYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 DIAZ ST
Mailing Address - Street 2:
Mailing Address - City:BROCKWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15824-1914
Mailing Address - Country:US
Mailing Address - Phone:814-771-8671
Mailing Address - Fax:
Practice Address - Street 1:98 DIAZ ST
Practice Address - Street 2:
Practice Address - City:BROCKWAY
Practice Address - State:PA
Practice Address - Zip Code:15824-1914
Practice Address - Country:US
Practice Address - Phone:814-771-8671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional