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General NPI Number Information
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NPI Number | 1700276748
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Entity Type | Organization
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Legal Business Name | STAR ACADEMY OF TOLEDO
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 5025 GLENDALE AVE DOOR #3
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City | TOLEDO
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State | OH
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Zip | 43614
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Country | US
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Telephone | 419-720-6330
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Fax | 419-720-7372
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Provider Business Mailing Address
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Address Line | 5025 GLENDALE AVE DOOR #3
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City | TOLEDO
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State | OH
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Zip | 43614
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Country | US
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Telephone | 419-720-6330
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Fax | 419-720-7372
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Authorized Official
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Title or Position | HEAD OF SCHOOL
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Name | MS. JULIETA R DINKINS
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Credential | M.ED
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Telephone | 419-720-6330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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