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General NPI Number Information
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NPI Number | 1831242445
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Entity Type | Organization
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Legal Business Name | DYSART UNIFIED SCHOOL DISTRICT
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 13700 W GREENWAY RD
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City | SURPRISE
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State | AZ
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Zip | 85374-5291
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Country | US
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Telephone | 623-876-7706
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Fax |
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Provider Business Mailing Address
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Address Line | 9462 N 94TH LN
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City | PEORIA
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State | AZ
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Zip | 85345-6370
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Country | US
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Telephone | 623-734-4477
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | TERESA M CHACE
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Credential |
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Telephone | 623-876-7706
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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 | #SLP4009
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License Number State | AZ
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