Provider Demographics
NPI:1376364208
Name:SNYDERBURN, KAYLA LYNN
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:LYNN
Last Name:SNYDERBURN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1832
Mailing Address - Country:US
Mailing Address - Phone:440-351-1919
Mailing Address - Fax:
Practice Address - Street 1:415 N ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1832
Practice Address - Country:US
Practice Address - Phone:440-351-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services