Organization
J T SCHOOL DISTRICT 2
Active
Other names
Village of White Lake & School District of White Lake
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH DOUGLAS WALL MSE (DIR OF SPECIAL EDUCATION)
(715) 882-2361
Entity
Organization
Contact information
Practice address
405 BISSELL STREET, WHITE LAKE, WI 54491-0067
(715) 882-2361
(715) 882-2914
Mailing address
PO BOX 67, 405 BISSELL STREET, WHITE LAKE, WI 54491-0067
(715) 882-2361
(715) 882-2914
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
079225
WI
225X00000X
Occupational Therapist
065019
WI
261QP2000X
Physical Therapy Clinic/Center
605019
WI
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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