Provider Demographics
NPI:1275747206
Name:FLAGSTAFF UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:FLAGSTAFF UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTA-MARIE
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:DOBOSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-779-7257
Mailing Address - Street 1:PO BOX 16001
Mailing Address - Street 2:
Mailing Address - City:BELLEMONT
Mailing Address - State:AZ
Mailing Address - Zip Code:86015-6001
Mailing Address - Country:US
Mailing Address - Phone:928-779-7257
Mailing Address - Fax:
Practice Address - Street 1:3285 E SPARROW AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-7794
Practice Address - Country:US
Practice Address - Phone:928-773-8220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========Medicaid