Doctor Name: | MS. SUSAN R WHITE |
NPI Number: | 1144555319 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., LLP |
License Number: | 6301008069 |
Business Practice Address: | 8303 Platt Rd Saline, MI - 481769773 |
Business Phone Number: | 7342954435 |
Business Fax Number: | 7342954898 |
Mailing Address: | 1411 Wagon Wheel Rd, CANTON |
State: | MI |
Postal Code: | 481881158 |
Phone Number: | 7342954435 |
Fax Number: | 7342954898 |
NPI Enumeration Date: | 10/06/2009 |
NPI Last Update Date: | 10/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301008069 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |