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General NPI Number Information
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NPI Number | 1790295533
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Entity Type | Organization
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Legal Business Name | SCHOOL DISTRICT #75
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 1489 E RIVER RD
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City | LIVINGSTON
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State | MT
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Zip | 59047-8718
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Country | US
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Telephone | 406-924-6865
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Fax | 406-924-6865
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Provider Business Mailing Address
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Address Line | PO BOX 37
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City | PRAY
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State | MT
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Zip | 59065-0037
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Country | US
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Telephone | 406-924-6865
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Fax | 406-924-6865
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Authorized Official
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Title or Position | DISTRICT CLERK
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Name | CINDA SELF
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Credential |
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Telephone | 406-924-6865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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