Healthcare Provider Details

I. General information

NPI: 1477129963
Provider Name (Legal Business Name): KAITLYN SNEDDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 MAPLE STREET
MORRISDALE PA
16858
US

IV. Provider business mailing address

PO BOX 40
LANSE PA
16849-0040
US

V. Phone/Fax

Practice location:
  • Phone: 814-345-5550
  • Fax:
Mailing address:
  • Phone: 814-345-5550
  • Fax: 814-345-5570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: