Provider Demographics
NPI:1518493576
Name:SNYDER, JOLENE MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:MARIE
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 1:107 BEAVER POND RD
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-9797
Mailing Address - Country:US
Mailing Address - Phone:406-498-1192
Mailing Address - Fax:
Practice Address - Street 1:209 TAYLOR DR
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-7103
Practice Address - Country:US
Practice Address - Phone:406-683-5806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12158628235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist