Healthcare Provider Details

I. General information

NPI: 1578870226
Provider Name (Legal Business Name): CHRISTINE SNYDER M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 WELLES ST STE 128
FORTY FORT PA
18704-4961
US

IV. Provider business mailing address

4 NEW ST
HUDSON PA
18705-3409
US

V. Phone/Fax

Practice location:
  • Phone: 570-522-9430
  • Fax:
Mailing address:
  • Phone: 570-677-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number06344
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL010431
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: