Provider Demographics
NPI:1154012771
Name:BRASELTON, SYDNEY SNIDER (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:SNIDER
Last Name:BRASELTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 LOWER STANDING ROCK RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:TN
Mailing Address - Zip Code:37058-5465
Mailing Address - Country:US
Mailing Address - Phone:731-307-6708
Mailing Address - Fax:
Practice Address - Street 1:1015 KELLEY DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5819
Practice Address - Country:US
Practice Address - Phone:731-642-2411
Practice Address - Fax:731-642-9447
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7975235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist