Provider Demographics
NPI:1841320454
Name:SNYDER, MARILEE B (LCSW, DCSW)
Entity type:Individual
Prefix:MS
First Name:MARILEE
Middle Name:B
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LCSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 IRIS AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2226
Mailing Address - Country:US
Mailing Address - Phone:303-413-6365
Mailing Address - Fax:303-449-6029
Practice Address - Street 1:1333 IRIS AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2226
Practice Address - Country:US
Practice Address - Phone:303-413-6365
Practice Address - Fax:303-449-6029
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7191041C0700X
IL149.0064611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical