Doctor Name: | GINA M WHITE |
NPI Number: | 1063694545 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 4808 |
Business Practice Address: | 102 Front Street Minocqua, WI - 54548 |
Business Phone Number: | 5127965994 |
Business Fax Number: | |
Mailing Address: | General Delivery, MINOCQUA |
State: | WI |
Postal Code: | 545489999 |
Phone Number: | 5127965994 |
Fax Number: | |
NPI Enumeration Date: | 11/27/2007 |
NPI Last Update Date: | 08/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4808 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |