Provider Demographics
NPI:1689206617
Name:SNELLGROVE, CAROLINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:SNELLGROVE
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 1:1011 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2506
Mailing Address - Country:US
Mailing Address - Phone:706-226-4623
Mailing Address - Fax:
Practice Address - Street 1:1011 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2506
Practice Address - Country:US
Practice Address - Phone:706-226-4623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist