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General NPI Number Information
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NPI Number | 1194516500
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Entity Type | Organization
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Legal Business Name | CUSTER SCHOOL DISTRICT 16-1
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 1415 WILD CAT LN
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City | CUSTER
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State | SD
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Zip | 57730-2478
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Country | US
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Telephone | 605-673-4483
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Fax |
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Provider Business Mailing Address
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Address Line | 527 MONTGOMERY ST
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City | CUSTER
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State | SD
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Zip | 57730-1124
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Country | US
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Telephone | 605-673-2171
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Fax |
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Authorized Official
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Title or Position | SPECIAL EDUCATION EVALUATOR
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Name | KATHERINE JENSEN
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Credential | ED.S
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Telephone | 605-673-2172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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