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General NPI Number Information
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NPI Number | 1548386147
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Entity Type | Organization
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Legal Business Name | NORTHWESTERN R-I SCHOOL
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/06/2015
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Provider Practice Location Address
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Address Line | 18475 HWY 11 NORTHWESTERN R-I SCHOOL
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City | MENDON
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State | MO
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Zip | 64660-0043
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Country | US
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Telephone | 660-272-3201
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Fax | 660-272-3419
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Provider Business Mailing Address
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Address Line | PO BOX 43 18475 HWY 11
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City | MENDON
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State | MO
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Zip | 64660-0043
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Country | US
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Telephone | 660-272-3201
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Fax | 660-272-3419
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Authorized Official
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Title or Position | DISTRICT COORDINATOR
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Name | MRS. LISA D GLADBACH
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Credential |
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Telephone | 660-272-3201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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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 |
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