Doctor Name: | STEPHANIE WHITE |
NPI Number: | 1003070913 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC005043 |
Business Practice Address: | 705 N Division St Nw Building 315 Rome, GA - 301651454 |
Business Phone Number: | 7068025870 |
Business Fax Number: | 7068025122 |
Mailing Address: | 1620 Hickory St, Suite 408 DALTON |
State: | GA |
Postal Code: | 307202312 |
Phone Number: | 7062705002 |
Fax Number: | 7062705111 |
NPI Enumeration Date: | 07/10/2008 |
NPI Last Update Date: | 05/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC005043 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |