Provider Demographics
NPI:1063455145
Name:SNYDER, KIMBERLY GRUBBS (OTR/L)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:GRUBBS
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 1:3990 COLUMBIA RD
Mailing Address - Street 2:PARTNERS IN ACHIEVEMENT, INC.
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2220
Mailing Address - Country:US
Mailing Address - Phone:706-650-1877
Mailing Address - Fax:706-860-3839
Practice Address - Street 1:3990 COLUMBIA RD
Practice Address - Street 2:PARTNERS IN ACHIEVEMENT, INC.
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-2220
Practice Address - Country:US
Practice Address - Phone:706-650-1877
Practice Address - Fax:706-860-3839
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003248225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics