Provider Demographics
NPI:1912673617
Name:SNOEYINK, DELLA
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:
Last Name:SNOEYINK
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:PO BOX 575
Mailing Address - Street 2:
Mailing Address - City:DIMONDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48821-0575
Mailing Address - Country:US
Mailing Address - Phone:616-780-2638
Mailing Address - Fax:
Practice Address - Street 1:355 HURONVIEW BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2949
Practice Address - Country:US
Practice Address - Phone:173-488-7870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-22
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist