Healthcare Provider Details

I. General information

NPI: 1386565000
Provider Name (Legal Business Name): MISS KAELYNN JOY SNEDEKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 DOUGLAS AVE FL 32714
ALTAMONTE SPRINGS FL
32714-2000
US

IV. Provider business mailing address

214 PALMETTO SPRINGS ST
DEBARY FL
32713-4814
US

V. Phone/Fax

Practice location:
  • Phone: 321-972-4265
  • Fax:
Mailing address:
  • Phone: 517-262-7975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: