Provider Demographics
NPI:1932376787
Name:SNYDER, KRISTA KELLEY (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:KELLEY
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11243 WOODBANK DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-9524
Mailing Address - Country:US
Mailing Address - Phone:205-534-0128
Mailing Address - Fax:
Practice Address - Street 1:507 ENERGY CENTER BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5825
Practice Address - Country:US
Practice Address - Phone:205-534-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0971235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist