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General NPI Number Information
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NPI Number | 1457621823
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Entity Type | Organization
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Legal Business Name | DOUGLAS EDUCATION SERVICE DISTRICT
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 1871 NE STEPHENS ST
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City | ROSEBURG
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State | OR
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Zip | 97470-1433
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Country | US
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Telephone | 541-440-4777
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Fax | 541-440-4771
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Provider Business Mailing Address
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Address Line | 1871 NE STEPHENS ST
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City | ROSEBURG
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State | OR
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Zip | 97470-1433
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Country | US
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Telephone | 541-440-4777
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Fax | 541-440-4771
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Authorized Official
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Title or Position | EI/ECSE REGIONAL DIRECTOR
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Name | SUSAN GRAHAM
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Credential |
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Telephone | 541-440-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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