Provider Demographics
NPI:1053747345
Name:SNYDER, JENNIFER M (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15821 SW 48TH MNR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5647
Mailing Address - Country:US
Mailing Address - Phone:305-788-7674
Mailing Address - Fax:
Practice Address - Street 1:2200 N COMMERCE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3258
Practice Address - Country:US
Practice Address - Phone:954-842-3643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6961103T00000X, 103TC0700X, 103TC2200X, 103TP2701X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool