Healthcare Provider Details

I. General information

NPI: 1821365206
Provider Name (Legal Business Name): CAROL THURLOW SNYDER MSED,CCCSLP,NYLICSLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROL SOUTHWICK THURLOW CCC-SLP, NYS LIC SLP

II. Dates (important events)

Enumeration Date: 11/29/2011
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 GICK RD
SARATOGA SPRINGS NY
12866-8517
US

IV. Provider business mailing address

43 TRUESDALE HILL RD
LAKE GEORGE NY
12845-7100
US

V. Phone/Fax

Practice location:
  • Phone: 518-581-3605
  • Fax:
Mailing address:
  • Phone: 518-668-3959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number003929-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: