Provider Demographics
NPI:1396464186
Name:SNOWDEN, CIARA
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:SNOWDEN
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 1:1098 BRANDY LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8440
Mailing Address - Country:US
Mailing Address - Phone:859-248-1036
Mailing Address - Fax:
Practice Address - Street 1:330 WALLER AVE STE 275
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2930
Practice Address - Country:US
Practice Address - Phone:859-447-8600
Practice Address - Fax:859-447-8599
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY280372225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty