Provider Demographics
NPI:1841061249
Name:SNYDER-PHAM, JEANNE QUYNH-TRAN
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:QUYNH-TRAN
Last Name:SNYDER-PHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13833 TARLETON CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-5900
Mailing Address - Country:US
Mailing Address - Phone:703-559-4541
Mailing Address - Fax:
Practice Address - Street 1:9309 CENTER ST
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5599
Practice Address - Country:US
Practice Address - Phone:443-690-5857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician