Provider Demographics
NPI:1912304924
Name:SNYDER, JENNIFER (MSW/LSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MSW/LSW
Other - Prefix:
Other - First Name:JENN
Other - Middle Name:
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1237 NIAGARA LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-9134
Mailing Address - Country:US
Mailing Address - Phone:317-460-9536
Mailing Address - Fax:
Practice Address - Street 1:1237 NIAGARA LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-9134
Practice Address - Country:US
Practice Address - Phone:317-460-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99064880A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker