Provider Demographics
NPI:1295405876
Name:SNYDER, COURTNEY THERESA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:THERESA
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 1:106 GREEN MOUNTAIN RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-6564
Mailing Address - Country:US
Mailing Address - Phone:985-817-1709
Mailing Address - Fax:
Practice Address - Street 1:3420 NE EVANGELINE TRWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2554
Practice Address - Country:US
Practice Address - Phone:337-534-8679
Practice Address - Fax:337-534-0027
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8358235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist