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General NPI Number Information
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NPI Number | 1912364936
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Entity Type | Organization
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Legal Business Name | CANNON COUNTY BOARD OF EDUCATION
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 06/29/2017
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Provider Practice Location Address
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Address Line | 301 W MAIN ST
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City | WOODBURY
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State | TN
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Zip | 37190-1100
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Country | US
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Telephone | 423-622-1551
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Fax | 877-856-7133
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Provider Business Mailing Address
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Address Line | PO BOX 8114
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City | CHATTANOOGA
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State | TN
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Zip | 37414-0114
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Country | US
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Telephone | 423-622-1551
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Fax | 877-856-7133
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Authorized Official
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Title or Position | DISTRICT SIGNEE
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Name | PAMELA PARKER
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Credential |
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Telephone | 615-563-5752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical 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 | 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 #3
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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 #4
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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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