Provider Demographics
NPI:1548442148
Name:SNYDER, MONICA (PROVISIONAL MFT)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PROVISIONAL MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14401 OLD CUTLER RD
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1722
Mailing Address - Country:US
Mailing Address - Phone:786-562-9179
Mailing Address - Fax:
Practice Address - Street 1:14401 OLD CUTLER RD
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33158-1722
Practice Address - Country:US
Practice Address - Phone:786-573-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMT136106H00000X
FLMT2928106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist