Provider Demographics
NPI:1275763781
Name:SNYDER, CAROLINE (CCC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17311 135TH AVE NE STE C200
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-3564
Mailing Address - Country:US
Mailing Address - Phone:425-486-7710
Mailing Address - Fax:425-483-6059
Practice Address - Street 1:17311 135TH AVE NE STE C200
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-3564
Practice Address - Country:US
Practice Address - Phone:425-486-7710
Practice Address - Fax:425-483-6059
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004610235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist