Provider Demographics
NPI:1649032756
Name:GALAN SNELL, IRENE
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:GALAN SNELL
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 1:2445 NW 31ST CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-6401
Mailing Address - Country:US
Mailing Address - Phone:954-665-6270
Mailing Address - Fax:
Practice Address - Street 1:2445 NW 31ST CT
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-6401
Practice Address - Country:US
Practice Address - Phone:954-665-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-322799106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician