Organization
SERENITY NEUROPSYCHOLOGY, PLLC
Active
Other names
Dr M. Snider PLLC, SERENITY NEUROPSYCHOLOGY & COUNSELING
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELODY LYNN SNIDER PHD (LICENSED PSYCHOLOGIST/OWNER)
(208) 957-5450
Entity
Organization
Contact information
Practice address
2498 N STOKESBERRY PL STE 150, MERIDIAN, ID 83646-5150
(208) 957-5450
(208) 957-5292
Mailing address
2498 N STOKESBERRY PL STE 150, MERIDIAN, ID 83646-5150
(208) 957-5450
(208) 957-5292
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY-202392
ID
103TC0700X
Clinical Psychologist
PSY-202392
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010162954
REGENCE BLUE SHIELD
ID
01
—
16200124
MEDICARE GROUP PIN
ID
01
—
1982734984
INDIVIDUAL NPI
ID
01
—
N6316
BLUE CROSS
ID
Enumeration date
11/16/2007
Last updated
01/09/2019
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