Provider Demographics
NPI:1932526365
Name:SNYDER, KURT M (LMFT)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11123 PARKVIEW PLAZA DR. STE 200
Mailing Address - Street 2:ATTN: WIELAND & ASSOCIATES
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845
Mailing Address - Country:US
Mailing Address - Phone:260-672-6510
Mailing Address - Fax:260-672-6501
Practice Address - Street 1:11123 PARKVIEW PLAZA DR.
Practice Address - Street 2:STE 200
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845
Practice Address - Country:US
Practice Address - Phone:260-672-6510
Practice Address - Fax:260-672-6501
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35-00181CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist