Healthcare Provider Details

I. General information

NPI: 1457429078
Provider Name (Legal Business Name): SPARTANBURG COUNTY SCHOOL DISTRICT NO. 5
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N. DANZLER RD
DUNCAN SC
29334
US

IV. Provider business mailing address

100 N. DANZLER RD
DUNCAN SC
29334
US

V. Phone/Fax

Practice location:
  • Phone: 864-949-2350
  • Fax: 864-439-0051
Mailing address:
  • Phone: 864-949-2350
  • Fax: 864-439-0051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. MAUREEN PATRICIA KRIESE
Title or Position: DIRECTOR OF SPECIAL SERVCIES
Credential: MSED
Phone: 864-949-2309