Provider Demographics
NPI:1336312313
Name:SCHOOL DISTRICT OF BLAIR TAYLOR
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF BLAIR TAYLOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-989-9835
Mailing Address - Street 1:219 S MAIN
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:WI
Mailing Address - Zip Code:54616
Mailing Address - Country:US
Mailing Address - Phone:608-989-2881
Mailing Address - Fax:
Practice Address - Street 1:219 S MAIN
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:WI
Practice Address - Zip Code:54616
Practice Address - Country:US
Practice Address - Phone:608-989-2881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management