Provider Demographics
NPI:1881799054
Name:SNYDER, AUDREY BETH
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:BETH
Last Name:SNYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 MILLSTONE RD
Mailing Address - Street 2:
Mailing Address - City:MILLSTONE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8509
Mailing Address - Country:US
Mailing Address - Phone:732-446-2461
Mailing Address - Fax:
Practice Address - Street 1:FAMILY GROWTH PROGRAM
Practice Address - Street 2:39 N. CLINTON AVE
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609
Practice Address - Country:US
Practice Address - Phone:609-394-5157
Practice Address - Fax:609-394-3010
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014285001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical