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NPI Code Detail

MEDICARE: TOLLESON ELEMENTARY SCHOOL DISTRICT NO. 17

MEDICARE: TOLLESON ELEMENTARY SCHOOL DISTRICT NO. 17
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
1251300000XLocal Education Agency (LEA)070417AZ

General Provider Information

NPI Number : 1821180878
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOLLESON ELEMENTARY SCHOOL DISTRICT NO. 17
Provider Business Mailing Address
First Line : 9261 W VAN BUREN ST
Second Line :
City : TOLLESON
State : AZ
Zip : 85353-2941
Country : US
Telephone Number : 623-936-9740
Fax Number : 623-907-5187
Provider Business Practice Location Address
First Line : 9261 W VAN BUREN ST
Second Line :
City : TOLLESON
State : AZ
Zip : 85353-2941
Country : US
Telephone Number : 623-936-9740
Fax Number : 623-907-5187
Authorized Official
Title or Position : ADMINISTRATOR FOR SPECIAL PROGRAMS
Name : DR. WANDA G. WILLIAMS
Credential : ED.D
Telephone Number : 623-936-9740
Provider Enumeration Date : 09/28/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1356351415 — RAKEESHA R REEVES M.A., CFY-SLP
Practice Location Address:
9261 W VAN BUREN ST
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Practice Phone: 623-907-5270
Practice Fax: 623-907-5271
1184717449 — MRS. MONICA ARLETT BUENSUCESO MA
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1164509188 — DEB JEAN DEDECKER MS OTR/L
Practice Location Address:
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TOLLESON, AZ
85353-2941
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Practice Fax: 623-907-5187
1669511903 — MRS. TARA CLEVELAND-DICKEY M.A.
Practice Location Address:
9261 W VAN BUREN ST
TOLLESON, AZ
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Practice Fax: 623-907-5187
1356486427 — MRS. KRISTEN ANN JOHNSON-PHELPS SR. MS
Practice Location Address:
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85353-2941
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1609904028 — MRS. CHRIS D. GUNDERSON R.N.
Practice Location Address:
9261 W VAN BUREN ST
TOLLESON, AZ
85353-2941
Practice Phone: 623-936-9740
Practice Fax: 623-907-5187

Directions to “TOLLESON ELEMENTARY SCHOOL DISTRICT NO. 17 ” Practice Location

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