Provider Demographics
NPI:1811910482
Name:SNYDER, ALLISON GAYLE (PHD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:GAYLE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21403 CHAGRIN BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5322
Mailing Address - Country:US
Mailing Address - Phone:216-848-0597
Mailing Address - Fax:
Practice Address - Street 1:21403 CHAGRIN BLVD STE 210
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5322
Practice Address - Country:US
Practice Address - Phone:216-848-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7056103TC0700X
LA986103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H907Medicare PIN