MEDICARE: GINA MARIE SNYDER M.A., CCC-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	361	CO

General Provider Information

NPI Number	:	1265649248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA MARIE SNYDER M.A., CCC-A

Provider Business Mailing Address
First Line	:	9123 W PHILLIPS DR
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-8120
Country	:	US
Telephone Number	:	303-979-3977
Fax Number	:

Provider Business Practice Location Address
First Line	:	7850 VANCE DR STE 195
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80003-2132
Country	:	US
Telephone Number	:	303-432-3601
Fax Number	:	303-432-3623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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