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General NPI Number Information
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NPI Number | 1124355136
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Entity Type | Individual
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Provider Name | CAROLYN ALLISA SNYDER R.D., L.D.
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Gender | Female
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Dates
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Enumeration Date | 11/11/2009
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 701 S BRADFORD ST NONE
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City | KIRKSVILLE
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State | MO
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Zip | 63501-5403
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Country | US
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Telephone | 785-317-5440
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Fax | 660-730-5042
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Provider Business Mailing Address
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Address Line | 701 S BRADFORD ST NONE
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City | KIRKSVILLE
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State | MO
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Zip | 63501-5403
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Country | US
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Telephone | 785-317-5440
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Fax | 660-730-5042
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1376
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2013014801
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License Number State | MO
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