Provider Demographics
NPI:1700152097
Name:SNYDER, VANESSA (PHD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
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 1:1325 SATELLITE BLVD NW
Mailing Address - Street 2:BLDG 100, STE 102
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4651
Mailing Address - Country:US
Mailing Address - Phone:678-764-4352
Mailing Address - Fax:770-813-1545
Practice Address - Street 1:515 E CROSSVILLE RD STE 140
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5861
Practice Address - Country:US
Practice Address - Phone:770-299-9410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006659101YP2500X
GAMFT001224106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional