Individual
JILISA SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
ANNA MARSH LANE, BRATTLEBORO, VT 05302
(802) 257-7785
Mailing address
PO BOX 101, BRATTLEBORO, VT 05302-0101
(802) 257-7785
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
048-0000301
VT
103TA0700X
Adult Development & Aging Psychologist
048-0000301
VT
103TB0200X
Cognitive & Behavioral Psychologist
Primary
048-0000301
VT
103TC0700X
Clinical Psychologist
048-0000301
VT
103TC1900X
Counseling Psychologist
048-0000301
VT
103TF0000X
Family Psychologist
048-0000301
VT
103TF0200X
Forensic Psychologist
048-0000301
VT
103TH0004X
Health Psychologist
048-0000301
VT
103TP2701X
Group Psychotherapy Psychologist
048-0000301
VT
103TR0400X
Rehabilitation Psychologist
048-0000301
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002645
—
VT
Enumeration date
07/10/2006
Last updated
11/15/2007
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