Healthcare Provider Details

I. General information

NPI: 1730240771
Provider Name (Legal Business Name): PAULDING COUNTY BOARD OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date: 06/03/2008
Reactivation Date: 08/07/2008

III. Provider practice location address

3236 ATLANTA HIGHWAY
DALLAS GA
30132-5725
US

IV. Provider business mailing address

3236 ATLANTA HIGHWAY
DALLAS GA
30132-5725
US

V. Phone/Fax

Practice location:
  • Phone: 770-443-8000
  • Fax: 770-443-7027
Mailing address:
  • Phone: 770-443-8000
  • Fax: 770-443-7027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateGA

VIII. Authorized Official

Name: DANNISON CURTIS
Title or Position: SPECIAL EDUCATION COORDINATOR
Credential: ED.S.
Phone: 770-443-8030