Provider Demographics
NPI:1679449599
Name:SNIDE, KATRINA
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:SNIDE
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 1:9 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05250-4457
Mailing Address - Country:US
Mailing Address - Phone:802-376-6566
Mailing Address - Fax:
Practice Address - Street 1:9 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05250-4457
Practice Address - Country:US
Practice Address - Phone:802-376-6566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.0135496390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program