Doctor Name: | MS. AMANDA JO WHITE |
NPI Number: | 1205171170 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 2484 |
Business Practice Address: | 207 Vivian St Hancock, MI - 499302132 |
Business Phone Number: | 4064372931 |
Business Fax Number: | |
Mailing Address: | 207 Vivian St, HANCOCK |
State: | MI |
Postal Code: | 499302132 |
Phone Number: | 4064372931 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2012 |
NPI Last Update Date: | 06/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2484 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |