Provider Demographics
NPI:1881955524
Name:SNAGGS, TANYA RENEE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:RENEE
Last Name:SNAGGS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:TANYA
Other - Middle Name:RENEE
Other - Last Name:EWAN-DESROSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 EAST 125TH STREET
Mailing Address - Street 2:NYP - SBHC @ PROMISE ACADEMY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035
Mailing Address - Country:US
Mailing Address - Phone:646-537-4231
Mailing Address - Fax:
Practice Address - Street 1:35 EAST 125TH STREET
Practice Address - Street 2:NYP - SBHC @ PROMISE ACADEMY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035
Practice Address - Country:US
Practice Address - Phone:646-537-4231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062498104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker