Provider Demographics
NPI:1306985601
Name:SNIDER, LILLIAN M (MA, LPC)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:M
Last Name:SNIDER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 BROADWAY
Mailing Address - Street 2:PO BOX 708
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-4200
Mailing Address - Country:US
Mailing Address - Phone:573-221-2120
Mailing Address - Fax:
Practice Address - Street 1:309 N MISSOURI ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:MO
Practice Address - Zip Code:63552-1747
Practice Address - Country:US
Practice Address - Phone:660-395-9114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999136660101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional