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Individual

MR. BRUCE E SNYDER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
117 BROAD ST, STROUDSBURG, PA 18360-1534
(570) 424-6049
(570) 424-0917
Mailing address
5 TARA DR, EAST STROUDSBURG, PA 18301-8810
(570) 629-4085

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS004106L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
054140
FPH PROV #
PA
01
454295
BLUE CROSS PROVIDER #
PA
01
5879430
AETNA PROV #
PA
01
77476000
MAGELLAN PROV #
PA
Enumeration date
03/16/2006
Last updated
07/08/2007
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