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General NPI Number Information
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NPI Number | 1821180878
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Entity Type | Organization
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Legal Business Name | TOLLESON ELEMENTARY SCHOOL DISTRICT NO. 17
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9261 W VAN BUREN ST
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City | TOLLESON
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State | AZ
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Zip | 85353-2941
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Country | US
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Telephone | 623-936-9740
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Fax | 623-907-5187
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Provider Business Mailing Address
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Address Line | 9261 W VAN BUREN ST
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City | TOLLESON
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State | AZ
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Zip | 85353-2941
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Country | US
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Telephone | 623-936-9740
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Fax | 623-907-5187
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Authorized Official
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Title or Position | ADMINISTRATOR FOR SPECIAL PROGRAMS
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Name | DR. WANDA G. WILLIAMS
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Credential | ED.D
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Telephone | 623-936-9740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 070417
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License Number State | AZ
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