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General NPI Number Information
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NPI Number | 1124356647
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Entity Type | Individual
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Provider Name | DANIELLE W SNODGRASS RRA
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Gender | Female
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 11/16/2024
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Provider Practice Location Address
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Address Line | 119 FISH OR CUT BAIT RD
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City | DEFUNIAK SPRINGS
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State | FL
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Zip | 32433-4630
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Country | US
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Telephone | 706-298-9434
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Fax |
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Provider Business Mailing Address
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Address Line | 119 FISH OR CUT BAIT RD
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City | DEFUNIAK SPRINGS
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State | FL
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Zip | 32433-4630
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Country | US
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Telephone | 706-298-9434
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Fax |
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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 | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | 2510
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | RTS-RT-LIC-25944
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | 321611
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License Number State |
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Taxonomy #4
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Taxonomy Code | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | RA77
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License Number State | FL
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