Individual
CHARLENE KAY SNIPES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3920 E HUNTINGTON DR, SUITE A, FLAGSTAFF, AZ 86004-9409
(602) 369-7328
Mailing address
453 E KIOWA ST, FLAGSTAFF, AZ 86001-9547
(602) 369-7328
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
0369
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
356396
PROVIDER AHCCCS ID NUMBER
AZ
Enumeration date
12/20/2008
Last updated
12/20/2008
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