Provider Demographics
NPI:1134830649
Name:SNYDERMAN, COURTNEY (MS, LBS, RBT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SNYDERMAN
Suffix:
Gender:F
Credentials:MS, LBS, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 WEST BALTIMORE PIKE
Mailing Address - Street 2:SUITE 100 B
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063
Mailing Address - Country:US
Mailing Address - Phone:610-572-5520
Mailing Address - Fax:610-572-5521
Practice Address - Street 1:77 WEST BALTIMORE PIKE
Practice Address - Street 2:SUITE 100 B
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063
Practice Address - Country:US
Practice Address - Phone:610-572-5520
Practice Address - Fax:610-572-5521
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARBT-21-196814106S00000X
PABH006276103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician