Provider Demographics
NPI:1265651731
Name:INDIAN OASIS-BABOQUIVARI UNIFIED SCHOOL DISTRICT 40
Entity Type:Organization
Organization Name:INDIAN OASIS-BABOQUIVARI UNIFIED SCHOOL DISTRICT 40
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PETTIGREW
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MED
Authorized Official - Phone:520-383-6713
Mailing Address - Street 1:111 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SELLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85634-0248
Mailing Address - Country:US
Mailing Address - Phone:520-383-6713
Mailing Address - Fax:520-383-5441
Practice Address - Street 1:111 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SELLS
Practice Address - State:AZ
Practice Address - Zip Code:85634-0248
Practice Address - Country:US
Practice Address - Phone:520-383-6713
Practice Address - Fax:520-383-5441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)