Provider Demographics
NPI:1235658691
Name:SNYDER, JEANNE RAE (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:RAE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 W CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TX
Mailing Address - Zip Code:76380-1553
Mailing Address - Country:US
Mailing Address - Phone:940-889-3862
Mailing Address - Fax:
Practice Address - Street 1:1136 W CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TX
Practice Address - Zip Code:76380-1553
Practice Address - Country:US
Practice Address - Phone:940-889-3862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12578235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist