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General NPI Number Information
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NPI Number | 1265651731
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Entity Type | Organization
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Legal Business Name | INDIAN OASIS-BABOQUIVARI UNIFIED SCHOOL DISTRICT 40
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 111 MAIN STREET
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City | SELLS
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State | AZ
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Zip | 85634-0248
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Country | US
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Telephone | 520-383-6713
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Fax | 520-383-5441
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Provider Business Mailing Address
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Address Line | 111 MAIN STREET
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City | SELLS
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State | AZ
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Zip | 85634-0248
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Country | US
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Telephone | 520-383-6713
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Fax | 520-383-5441
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Authorized Official
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Title or Position | SCHOOL PSYCHOLOGIST
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Name | MS. JANICE SUE PETTIGREW
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Credential | M.S., M.ED.
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Telephone | 520-383-6713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | AZ
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