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NPI Code Detail

MEDICARE: PULASKI COUNTY PUBLIC SCHOOLS

MEDICARE: PULASKI COUNTY PUBLIC SCHOOLS
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
1103TS0200XSchool Psychologist0813000169VA

General Provider Information

NPI Number : 1396250700
Entity Type Code : Organization
Provider Name (Legal Business Name) : PULASKI COUNTY PUBLIC SCHOOLS
Provider Business Mailing Address
First Line : 202 NORTH WASHINGTON AVENUE
Second Line :
City : PULASKI
State : VA
Zip : 24301
Country : US
Telephone Number : 540-994-2544
Fax Number : 540-994-2560
Provider Business Practice Location Address
First Line : 202 N WASHINGTON AVE
Second Line :
City : PULASKI
State : VA
Zip : 24301-5022
Country : US
Telephone Number : 540-994-2544
Fax Number : 540-994-2560
Authorized Official
Title or Position : SCHOOL PSYCHOLOGIST
Name : DR. KEVIN WAYNE SIERS
Credential : ED.D.
Telephone Number : 540-994-2519
Provider Enumeration Date : 12/07/2017
Last Update Date : 12/07/2017

Similar Medicare Providers

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Directions to “PULASKI COUNTY PUBLIC SCHOOLS ” Practice Location

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