Provider Demographics
NPI:1083953707
Name:SNIPES, BRUCE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:SNIPES
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2348 SAVANNAH GROVE RD
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:SC
Mailing Address - Zip Code:29541-6352
Mailing Address - Country:US
Mailing Address - Phone:843-664-8463
Mailing Address - Fax:843-664-8185
Practice Address - Street 1:2348 SAVANNAH GROVE RD
Practice Address - Street 2:SAVANNAH GROVE ELEMENTARY
Practice Address - City:EFFINGHAM
Practice Address - State:SC
Practice Address - Zip Code:29541-9522
Practice Address - Country:US
Practice Address - Phone:843-664-8463
Practice Address - Fax:843-664-8185
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2306235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist