Provider Demographics
NPI:1215666342
Name:SNYDER, LILLIE KIRSTEN (OTR/L)
Entity type:Individual
Prefix:
First Name:LILLIE
Middle Name:KIRSTEN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 STONEY POINT CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5204
Mailing Address - Country:US
Mailing Address - Phone:281-515-8212
Mailing Address - Fax:
Practice Address - Street 1:2656 S LOOP W STE 170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2639
Practice Address - Country:US
Practice Address - Phone:281-786-4234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122739225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist