Healthcare Provider Details

I. General information

NPI: 1184964421
Provider Name (Legal Business Name): CARRIE LYNN SNYDER M.S., BCBA, COBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2013
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 WINDHAM CT SUITE 4
BOARDMAN OH
44512-5083
US

IV. Provider business mailing address

3762 FAIRFIELD SCHOOL RD
COLUMBIANA OH
44408-9610
US

V. Phone/Fax

Practice location:
  • Phone: 330-502-0817
  • Fax:
Mailing address:
  • Phone: 330-502-0817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-11-9441
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: