Healthcare Provider Details

I. General information

NPI: 1679407183
Provider Name (Legal Business Name): KATHERINE GRACE SNEDIKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 PALM BEACH LAKES BLVD STE 1200
WEST PALM BEACH FL
33401-2214
US

IV. Provider business mailing address

499 EVERNIA ST APT 338
WEST PALM BEACH FL
33401-5454
US

V. Phone/Fax

Practice location:
  • Phone: 561-662-7315
  • Fax:
Mailing address:
  • Phone: 704-609-5170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: