Provider Demographics
NPI:1902135676
Name:ANSELMI-SNYDER, LORA ROSEMARY (MA)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:ROSEMARY
Last Name:ANSELMI-SNYDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ROSEMARY
Other - Last Name:ANSELMI-SNYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:253-681-6626
Mailing Address - Fax:
Practice Address - Street 1:3801 150TH AVE SE FL 3
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1668
Practice Address - Country:US
Practice Address - Phone:254-607-1144
Practice Address - Fax:254-607-1154
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61306328101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor