Provider Information for 1528196375
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KELLY L SNYDER LPC-MHSP
Sex: Female
NPI: 1528196375
Last Updated: 2019-12-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1528196375 | ||||||||
| Enumeration Date | 2007-03-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2966 LYLEWOOD RD WOODLAWN, TN 37191-8206 United States Phone: 931-472-9102 | Fax: | ||||||||
| Primary Practice Address | 6000 RAMSEY WAY DICKSON, TN 37055-2198 United States Phone: 615-446-3797 | Fax:615-446-5852 | ||||||||
| Secondary Practice Address(es) | 1820 MEMORIAL CIR | ||||||||
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