Individual
BREANNA SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 LAKE HAVASU AVE N, LAKE HAVASU CITY, AZ 86404-1177
(928) 854-5439
(928) 854-5440
Mailing address
1515 LAKE HAVASU AVE N, LAKE HAVASU CITY, AZ 86404-1177
(928) 854-5439
(928) 854-5440
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6378
ARIZONA STATE BOARD OF OCCUPATIONAL THERAPY
AZ
Enumeration date
06/16/2016
Last updated
06/16/2016
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