Basic Information
Provider Information
NPI: 1134529027
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNYDER
FirstName: HD HILA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SNYDER
OtherFirstName: HILLARY
OtherMiddleName: D
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 10I ROESSLER RD
Address2:  
City: WOBURN
State: MA
PostalCode: 018016208
CountryCode: US
TelephoneNumber: 7819328114
FaxNumber:  
Practice Location
Address1: 10I ROESSLER RD
Address2:  
City: WOBURN
State: MA
PostalCode: 01801
CountryCode: US
TelephoneNumber: 7819328114
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/27/2014
LastUpdateDate: 08/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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