Healthcare Provider Details

I. General information

NPI: 1811442460
Provider Name (Legal Business Name): KAITLIN SNAPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 PENINSULA CORPORATE CIR STE 1014
BOCA RATON FL
33487-1385
US

IV. Provider business mailing address

5301 CNTRL GRDNS WAY APT 203
PALM BEACH GARDENS FL
33418-4081
US

V. Phone/Fax

Practice location:
  • Phone: 813-763-3023
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ 7744
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: