Provider Demographics
NPI:1235828104
Name:SNYDER, PAMELA HOWARD (LCSW)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:HOWARD
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:HOWARD
Other - Last Name:GOFFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:130 S 18TH ST UNIT 401
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-4924
Mailing Address - Country:US
Mailing Address - Phone:561-999-0899
Mailing Address - Fax:
Practice Address - Street 1:130 S 18TH ST UNIT 401
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4924
Practice Address - Country:US
Practice Address - Phone:561-999-0899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW53741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical