Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 37CA00074800 | NJ |
NPI | 1003048695 |
---|---|
Provider Name | Robert Anthony Snyder |
First Address | Mays Landing, NJ 08330-1435 |
Second Address | Pittsgrove, NJ 08318-4401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2009 |
Last Update Date | 14/08/2009 |