Healthcare Provider Details

I. General information

NPI: 1649420415
Provider Name (Legal Business Name): CARA BOOLOS SNABLE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 10TH AVE S
BIRMINGHAM AL
35205-1200
US

IV. Provider business mailing address

2700 10TH AVE S
BIRMINGHAM AL
35205-1200
US

V. Phone/Fax

Practice location:
  • Phone: 205-212-3310
  • Fax: 205-933-5893
Mailing address:
  • Phone: 205-212-3310
  • Fax: 205-933-5893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1002A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: