=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477694149
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GILBERT PUBLIC SCHOOLS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1101 N RECKER RD
-----------------------------------------------------
City | HIGLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85236-3319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-854-1545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3861 S DEW DROP LN
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85297-8026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-775-2585
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SCHOOL PSYCHOLOGIST
-----------------------------------------------------
Name | DR. AMY NICOLE SCOTT
-----------------------------------------------------
Credential | PH.D., NCSP
-----------------------------------------------------
Telephone | 480-854-1545
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------