Provider Demographics
NPI:1952777435
Name:SNYDER, ANA M (LMT)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 W EL CAMINO DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-9124
Mailing Address - Country:US
Mailing Address - Phone:602-799-3336
Mailing Address - Fax:602-589-6212
Practice Address - Street 1:5842 W MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1875
Practice Address - Country:US
Practice Address - Phone:602-799-3336
Practice Address - Fax:602-589-6212
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-00526P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist