1033722624 NPI number — REGINA ANN FLANIGAN SNYDER LCPC

Table of content: REGINA ANN FLANIGAN SNYDER LCPC (NPI 1033722624)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033722624 NPI number — REGINA ANN FLANIGAN SNYDER LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLANIGAN SNYDER
Provider First Name:
REGINA
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLANIGAN
Provider Other First Name:
REGINA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033722624
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4076 E HYATT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IJAMSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21754-9500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-409-0042
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 N BENTZ ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21701-4913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-409-0042
Provider Business Practice Location Address Fax Number:
301-631-2937
Provider Enumeration Date:
08/25/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  1684 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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