Provider Demographics
NPI:1851905434
Name:SNIDER, ALANA (SLP)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:SNIDER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 EMORY ST
Mailing Address - Street 2:
Mailing Address - City:FLORA
Mailing Address - State:IL
Mailing Address - Zip Code:62839-2701
Mailing Address - Country:US
Mailing Address - Phone:618-662-2014
Mailing Address - Fax:
Practice Address - Street 1:445 EMORY ST
Practice Address - Street 2:
Practice Address - City:FLORA
Practice Address - State:IL
Practice Address - Zip Code:62839-2701
Practice Address - Country:US
Practice Address - Phone:618-662-2014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.006086261QS1000X
IL146.016013261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health