Basic Information
| Provider Information | |||||||||
| NPI: | 1366477457 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SNYDER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PSYD., LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7945 STONE CREEK DR | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | CHANHASSEN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553174605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529743999 | ||||||||
| FaxNumber: | 9529743780 | ||||||||
| Practice Location | |||||||||
| Address1: | 7945 STONE CREEK DR | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | CHANHASSEN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553174605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529743999 | ||||||||
| FaxNumber: | 9529743780 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | LP3478 | MN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.