Provider Demographics
NPI:1447033915
Name:SNYDER, NIKKI MICHELLE (LSW, DSW)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:MICHELLE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LSW, DSW
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:MICHELLE
Other - Last Name:KOYSTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, DSW
Mailing Address - Street 1:1235 PENN AVE STE 205-206
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2100
Mailing Address - Country:US
Mailing Address - Phone:610-374-4963
Mailing Address - Fax:610-378-5403
Practice Address - Street 1:1235 PENN AVE STE 205-206
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2100
Practice Address - Country:US
Practice Address - Phone:610-374-4963
Practice Address - Fax:610-378-5403
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131697104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker