Provider Demographics
NPI:1447485685
Name:SNYDER, ERIN NICOLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:NICOLE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1250 TOWNSHIP ROAD 16
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:OH
Mailing Address - Zip Code:43334-9739
Mailing Address - Country:US
Mailing Address - Phone:419-768-3040
Mailing Address - Fax:
Practice Address - Street 1:1250 TOWNSHIP ROAD 16
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:OH
Practice Address - Zip Code:43334-9739
Practice Address - Country:US
Practice Address - Phone:419-768-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP1196235Z00000X
OH13522235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist