Provider Demographics
NPI:1194448738
Name:SNYDER, GABRIEL ISAAC
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:ISAAC
Last Name:SNYDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MISSION AUTISM CLINICS
Mailing Address - Street 2:9 BANKS AVENUE
Mailing Address - City:MCADOO
Mailing Address - State:PA
Mailing Address - Zip Code:18237-2508
Mailing Address - Country:US
Mailing Address - Phone:888-726-4774
Mailing Address - Fax:
Practice Address - Street 1:MISSION AUTISM CLINICS
Practice Address - Street 2:9 BANKS AVENUE
Practice Address - City:MCADOO
Practice Address - State:PA
Practice Address - Zip Code:18237-2508
Practice Address - Country:US
Practice Address - Phone:888-726-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician