Healthcare Provider Details

I. General information

NPI: 1518555499
Provider Name (Legal Business Name): KINIMO M SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8104 VISTA AVE
GARFIELD HTS OH
44125-2064
US

IV. Provider business mailing address

8104 VISTA AVE
GARFIELD HTS OH
44125-2064
US

V. Phone/Fax

Practice location:
  • Phone: 216-965-8998
  • Fax:
Mailing address:
  • Phone: 216-965-8998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: