Provider Demographics
NPI:1801088554
Name:DONIPHAN REORGANIZED SCHOOL
Entity type:Organization
Organization Name:DONIPHAN REORGANIZED SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-996-3982
Mailing Address - Street 1:603 E SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:MO
Mailing Address - Zip Code:63935-1142
Mailing Address - Country:US
Mailing Address - Phone:573-996-3982
Mailing Address - Fax:573-996-2763
Practice Address - Street 1:603 E SUMMIT ST
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:MO
Practice Address - Zip Code:63935-1142
Practice Address - Country:US
Practice Address - Phone:573-996-3982
Practice Address - Fax:573-996-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X, 225X00000X
MO2002000259235Z00000X
MO111784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty