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General NPI Number Information
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NPI Number | 1679596092
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Entity Type | Organization
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Legal Business Name | AVONDALE ELEMENTARY SCHOOL DISTRICT #44
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 235 W WESTERN AVE
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City | AVONDALE
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State | AZ
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Zip | 85323-1848
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Country | US
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Telephone | 623-772-5091
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Fax | 623-772-5090
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Provider Business Mailing Address
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Address Line | 235 W WESTERN AVE
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City | AVONDALE
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State | AZ
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Zip | 85323-1848
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Country | US
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Telephone | 623-772-5091
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Fax | 623-772-5090
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MRS. PAT PERRYMAN
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Credential | DIRECTOR
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Telephone | 623-772-5091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | RN043598
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License Number State | AZ
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