Provider Demographics
NPI:1801505458
Name:SNIDER, GEORGIA MARIE (RBT-22-244357)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:MARIE
Last Name:SNIDER
Suffix:
Gender:F
Credentials:RBT-22-244357
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-5034
Mailing Address - Country:US
Mailing Address - Phone:786-856-4060
Mailing Address - Fax:
Practice Address - Street 1:1935 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-5034
Practice Address - Country:US
Practice Address - Phone:786-856-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-244357106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician