Provider Demographics
NPI:1720209760
Name:PANTHER VALLEY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:PANTHER VALLEY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHALIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-645-0386
Mailing Address - Street 1:1 PANTHER WAY
Mailing Address - Street 2:
Mailing Address - City:LANSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18232-1929
Mailing Address - Country:US
Mailing Address - Phone:570-645-3176
Mailing Address - Fax:570-645-2507
Practice Address - Street 1:1 PANTHER WAY
Practice Address - Street 2:
Practice Address - City:LANSFORD
Practice Address - State:PA
Practice Address - Zip Code:18232-1929
Practice Address - Country:US
Practice Address - Phone:570-645-3176
Practice Address - Fax:570-645-2507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA199300216103TS0200X
PA170422512235Z00000X
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty