Provider Demographics
NPI:1922637305
Name:SNELLING, CARRIE ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:SNELLING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 SUNNINGTON GROVE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-6001
Mailing Address - Country:US
Mailing Address - Phone:513-649-1030
Mailing Address - Fax:
Practice Address - Street 1:1608 SUNNINGTON GROVE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-6001
Practice Address - Country:US
Practice Address - Phone:513-649-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03325264183500000X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No183500000XPharmacy Service ProvidersPharmacist