Provider Demographics
NPI:1326123720
Name:SNOWFLAKE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SNOWFLAKE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/SUB-TEACHER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:GARRETT-ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:909-536-4156
Mailing Address - Street 1:141 CREEKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-2822
Mailing Address - Country:US
Mailing Address - Phone:928-537-0055
Mailing Address - Fax:
Practice Address - Street 1:682 SCHOOL BUS LANE
Practice Address - Street 2:SNOWFLAKE SCHOOL DISTRICT
Practice Address - City:SNOWFLAKE
Practice Address - State:AZ
Practice Address - Zip Code:85937-0000
Practice Address - Country:US
Practice Address - Phone:928-536-4156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5983251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)