Provider Demographics
NPI:1962691493
Name:SNYDER, EDWARD PAUL (PHD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:PAUL
Last Name:SNYDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 PEACH ST
Mailing Address - Street 2:NORTH WING - SUITE 2
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1358
Mailing Address - Country:US
Mailing Address - Phone:814-864-9155
Mailing Address - Fax:
Practice Address - Street 1:409 ARMORE AVENUE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505
Practice Address - Country:US
Practice Address - Phone:814-864-9155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016261103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist