Provider Demographics
NPI:1578839411
Name:GIBBON PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:GIBBON PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:308-468-6546
Mailing Address - Street 1:1030 COURT ST
Mailing Address - Street 2:
Mailing Address - City:GIBBON
Mailing Address - State:NE
Mailing Address - Zip Code:68840-4064
Mailing Address - Country:US
Mailing Address - Phone:308-468-6546
Mailing Address - Fax:308-468-9139
Practice Address - Street 1:1030 COURT ST
Practice Address - Street 2:
Practice Address - City:GIBBON
Practice Address - State:NE
Practice Address - Zip Code:68840-4064
Practice Address - Country:US
Practice Address - Phone:308-468-6546
Practice Address - Fax:308-468-9139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2010006208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty