MEDICARE: WORTH COUNTY RIII SCHOOL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1154478923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORTH COUNTY RIII SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	RR 3 BOX 107
Second Line	:
City	:	GRANT CITY
State	:	MO
Zip	:	64456-8833
Country	:	US
Telephone Number	:	660-564-3389
Fax Number	:	660-564-2193

Provider Business Practice Location Address
First Line	:	RR 3 BOX 107
Second Line	:
City	:	GRANT CITY
State	:	MO
Zip	:	64456-8833
Country	:	US
Telephone Number	:	660-564-3389
Fax Number	:	660-564-2193

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	DR. LINDA GRAY SMITH
Credential	:
Telephone Number	:	660-564-3389

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/22/2020

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Directions to “WORTH COUNTY RIII SCHOOL DISTRICT ” Practice Location

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