Provider Demographics
NPI:1508297821
Name:SNEDEGAR, CLINT M (NBC/HIS)
Entity Type:Individual
Prefix:
First Name:CLINT
Middle Name:M
Last Name:SNEDEGAR
Suffix:
Gender:M
Credentials:NBC/HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5074 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1526
Mailing Address - Country:US
Mailing Address - Phone:614-431-1010
Mailing Address - Fax:614-847-0015
Practice Address - Street 1:5074 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1526
Practice Address - Country:US
Practice Address - Phone:614-431-1010
Practice Address - Fax:614-847-0015
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2174237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2174OtherSTATE LICENSE