| Organization Name: | ALICE WOODSON WHITE |
| NPI Number: | 1043583131 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALICE MIRIAM WOODSON WHITE (SOLEPROPRIETOR/MENTALHEALTHTHERAPY) |
| Mailing Address: | 290 Main St Suite 5a Setauket |
| State: | NY US |
| Postal Code: | 117332871 |
| Phone Number: | 6316759494 |
| Fax Number: | |
| NPI Enumeration Date: | 02/20/2012 |
| NPI Last Update Date: | 08/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0720745441 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |