Provider Demographics
NPI:1710630975
Name:SHICKLEY PUBLIC SCHOOL
Entity Type:Organization
Organization Name:SHICKLEY PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERISSA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZAJIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-627-3375
Mailing Address - Street 1:104 E MURRAY ST # 407
Mailing Address - Street 2:
Mailing Address - City:SHICKLEY
Mailing Address - State:NE
Mailing Address - Zip Code:68436-3033
Mailing Address - Country:US
Mailing Address - Phone:402-627-3375
Mailing Address - Fax:
Practice Address - Street 1:104 E MURRAY ST
Practice Address - Street 2:
Practice Address - City:SHICKLEY
Practice Address - State:NE
Practice Address - Zip Code:68436-3033
Practice Address - Country:US
Practice Address - Phone:402-627-3375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)