Provider Demographics
NPI:1396092599
Name:SNEL, DANA NICOLE (ATC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:NICOLE
Last Name:SNEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ROCKLEDGE TER
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1508
Mailing Address - Country:US
Mailing Address - Phone:201-704-7622
Mailing Address - Fax:
Practice Address - Street 1:25 ROCKLEDGE TER
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1508
Practice Address - Country:US
Practice Address - Phone:201-704-7622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT00177300390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program