Provider Demographics
NPI:1144474800
Name:SNYDER, CARLI (PHD)
Entity type:Individual
Prefix:
First Name:CARLI
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7455 W WASHINGTON AVE STE 160
Mailing Address - Street 2:LONGFORD MEDICAL CENTER
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4337
Mailing Address - Country:US
Mailing Address - Phone:702-252-8255
Mailing Address - Fax:702-380-8255
Practice Address - Street 1:7455 W WASHINGTON AVE STE 160
Practice Address - Street 2:LONGFORD MEDICAL CENTER
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4337
Practice Address - Country:US
Practice Address - Phone:702-252-8255
Practice Address - Fax:702-380-8255
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0490103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical