Provider Information for 1902564917
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MISHA SHERON SNIDER LCSW
Sex: Female
NPI: 1902564917
Last Updated: 2021-12-07
Certification Date: 2021-12-07
Certification Date: 2021-12-07
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1902564917 | ||||||||
| Enumeration Date | 2021-12-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 16323 SAVANNAH, GA 31416-3023 United States Phone: 912-414-1391 | Fax: | ||||||||
| Primary Practice Address | 125 BORDEAUX LN SAVANNAH, GA 31419-2865 United States Phone: 912-414-1391 | Fax: | ||||||||
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