Provider Demographics
NPI:1396073235
Name:SNYDER, KRISTI ANN (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:ANN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5508 FANTASY MOTH DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7166
Mailing Address - Country:US
Mailing Address - Phone:631-896-9180
Mailing Address - Fax:
Practice Address - Street 1:146 STATE HOUSE STA
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04333-2147
Practice Address - Country:US
Practice Address - Phone:207-624-6660
Practice Address - Fax:207-624-6661
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019654235Z00000X
LA7574235Z00000X
MESP2780235Z00000X
NC11901235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03639094Medicaid