Healthcare Provider Details

I. General information

NPI: 1598952079
Provider Name (Legal Business Name): DYSART UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 09/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11405 N DYSART RD
EL MIRAGE AZ
85335-9233
US

IV. Provider business mailing address

22610 N LAS BRIZAS LN
SUN CITY WEST AZ
85375-2829
US

V. Phone/Fax

Practice location:
  • Phone: 623-523-8300
  • Fax:
Mailing address:
  • Phone: 623-214-6950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. ROXANE KUNZ
Title or Position: SCHOL PSYCHOLOGIST
Credential: M.A.
Phone: 623-523-8300