MEDICARE: KARLY RAE SNOW MA CCC-SLP

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
2	235Z00000X	Speech-Language Pathologist	SL012873	PA

General Provider Information

NPI Number	:	1972981165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLY RAE SNOW MA CCC-SLP

Provider Business Mailing Address
First Line	:	4055 MONROEVILLE BLVD
Second Line	:	CORP ONE OFFICE PARK, BUILDING ONE SUITE 450
City	:	MONROEVILLE
State	:	PA
Zip	:	15146
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4470 BROWNSVILLE RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-1908
Country	:	US
Telephone Number	:	484-560-6471
Fax Number	:

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

Provider Enumeration Date	:	05/08/2015
Last Update Date	:	03/17/2018

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Directions to “ KARLY RAE SNOW MA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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