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General NPI Number Information
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NPI Number | 1003966383
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Entity Type | Organization
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Legal Business Name | YADKIN COUNTY SCHOOLS
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3801B RIVER ROAD
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City | BOONVILLE
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State | NC
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Zip | 27011-8341
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Country | US
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Telephone | 336-367-5187
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Fax | 336-367-3062
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Provider Business Mailing Address
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Address Line | 121 WASHINGTON ST
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City | YADKINVILLE
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State | NC
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Zip | 27055-7725
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Country | US
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Telephone | 336-367-5187
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Fax | 336-367-3062
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Authorized Official
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Title or Position | ADVP DIRECTOR
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Name | MRS. TERRI MIKLES VESTAL
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Credential |
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Telephone | 33633675187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | MHL-099-002
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License Number State | NC
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