Provider Demographics
NPI:1285365502
Name:SNYDER, MELINDA ROSE (OTR/L)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ROSE
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 1:3108 LA ENTRADA ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-3607
Mailing Address - Country:US
Mailing Address - Phone:949-357-9144
Mailing Address - Fax:
Practice Address - Street 1:301 N PECOS RD STE A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-1350
Practice Address - Country:US
Practice Address - Phone:702-566-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16-0820225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist