MEDICARE: KRISTIN SNOW

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	235Z00000X	Speech-Language Pathologist	30002866	NC

General Provider Information

NPI Number	:	1760228795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN SNOW

Provider Business Mailing Address
First Line	:	1824 MERRIMAN AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-4612
Country	:	US
Telephone Number	:	703-509-4107
Fax Number	:

Provider Business Practice Location Address
First Line	:	12019 VERHOEFF DR
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-9217
Country	:	US
Telephone Number	:	703-509-4107
Fax Number	:

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

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	07/09/2024

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Directions to “ KRISTIN SNOW ” Practice Location

Language	Start Address	Practice Location

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