Provider Demographics
NPI:1831697333
Name:SNYDER, JENNA DARA (LPCA)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:DARA
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E WASHINGTON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2993
Mailing Address - Country:US
Mailing Address - Phone:336-333-6860
Mailing Address - Fax:336-275-1187
Practice Address - Street 1:301 E WASHINGTON ST STE 101
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2993
Practice Address - Country:US
Practice Address - Phone:336-333-6860
Practice Address - Fax:336-275-1187
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional