Healthcare Provider Details

I. General information

NPI: 1982753539
Provider Name (Legal Business Name): GILBERT UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N GREENFIELD RD
GILBERT AZ
85234-6220
US

IV. Provider business mailing address

1321 E CATCLAW ST
GILBERT AZ
85296-2513
US

V. Phone/Fax

Practice location:
  • Phone: 480-558-5131
  • Fax:
Mailing address:
  • Phone: 480-636-7045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE KROLL
Title or Position: SCHOOL PSYCHOLOGIST
Credential:
Phone: 480-558-5131