Provider Demographics
NPI:1245631357
Name:SNOW, CAROLYN (MS, LAT, ATC, OTC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:MS, LAT, ATC, OTC
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:ISBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LAT, ATC, OTC
Mailing Address - Street 1:13340 HIGHLAND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-2000
Mailing Address - Country:US
Mailing Address - Phone:682-885-4405
Mailing Address - Fax:
Practice Address - Street 1:13340 HIGHLAND HILLS DR
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-2000
Practice Address - Country:US
Practice Address - Phone:682-885-4405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT47102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer