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General NPI Number Information
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NPI Number | 1396250700
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Entity Type | Organization
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Legal Business Name | PULASKI COUNTY PUBLIC SCHOOLS
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 202 N WASHINGTON AVE
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City | PULASKI
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State | VA
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Zip | 24301-5022
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Country | US
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Telephone | 540-994-2544
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Fax | 540-994-2560
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Provider Business Mailing Address
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Address Line | 202 NORTH WASHINGTON AVENUE
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City | PULASKI
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State | VA
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Zip | 24301
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Country | US
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Telephone | 540-994-2544
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Fax | 540-994-2560
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Authorized Official
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Title or Position | SCHOOL PSYCHOLOGIST
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Name | DR. KEVIN WAYNE SIERS
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Credential | ED.D.
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Telephone | 540-994-2519
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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 | 0813000169
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License Number State | VA
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