Provider Demographics
NPI:1770220451
Name:SNIDER, TAYLOR ELIZABETH (LPC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:SNIDER
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ELIZABETH
Other - Last Name:DIMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6704 WOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6145
Mailing Address - Country:US
Mailing Address - Phone:254-892-4957
Mailing Address - Fax:
Practice Address - Street 1:1402 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-5814
Practice Address - Country:US
Practice Address - Phone:405-533-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10756101YP2500X
TX91703101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health