Provider Demographics
NPI:1477663185
Name:SNOW, CELIA LIPPITT (MS,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CELIA
Middle Name:LIPPITT
Last Name:SNOW
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 1:122 BROOKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1110
Mailing Address - Country:US
Mailing Address - Phone:910-612-2814
Mailing Address - Fax:910-341-7908
Practice Address - Street 1:122 BROOKWOOD AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1110
Practice Address - Country:US
Practice Address - Phone:910-612-2814
Practice Address - Fax:910-341-7908
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4584235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC135TYOtherBCBS PROVIDER NUMBER
NC7411502Medicaid