Provider Demographics
NPI:1871773580
Name:PULASKI COUNTY SPECIAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:PULASKI COUNTY SPECIAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:501-897-2171
Mailing Address - Street 1:14300 DINEEN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-5820
Mailing Address - Country:US
Mailing Address - Phone:501-897-2171
Mailing Address - Fax:501-897-2128
Practice Address - Street 1:14300 DINEEN DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-5820
Practice Address - Country:US
Practice Address - Phone:501-897-2171
Practice Address - Fax:501-897-2128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1558251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)