Provider Demographics
NPI:1467265405
Name:SNYDER, SAMANTHA RENEE (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:RENEE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870-7807
Mailing Address - Country:US
Mailing Address - Phone:570-259-9119
Mailing Address - Fax:
Practice Address - Street 1:132 THE MEADOWS DR
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828-9231
Practice Address - Country:US
Practice Address - Phone:814-364-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031710363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health