Healthcare Provider Details

I. General information

NPI: 1982196077
Provider Name (Legal Business Name): SARA SNAPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 TECH BLVD STE 122
TAMPA FL
33619-7822
US

IV. Provider business mailing address

3703 KITMORE PL
VALRICO FL
33596-6904
US

V. Phone/Fax

Practice location:
  • Phone: 813-763-3219
  • Fax:
Mailing address:
  • Phone: 813-763-3219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-17-42271
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-37396
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: