Healthcare Provider Details

I. General information

NPI: 1184742769
Provider Name (Legal Business Name): CAROLYN MEYERS SNYDER MS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN ANN MEYERS MS CCC SLP

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3302 W 116TH ST
CARMEL IN
46032
US

IV. Provider business mailing address

601 STADIUM MALL DRIVE
WEST LAFAYETTE IN
47907-2052
US

V. Phone/Fax

Practice location:
  • Phone: 317-698-9089
  • Fax: 317-733-8157
Mailing address:
  • Phone: 765-496-1927
  • Fax: 765-496-1227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22001776A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: