Doctor Name: | WILLIAM EUGENE WHITE |
NPI Number: | 1477734465 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 2007033159 |
Business Practice Address: | 13160 County Rd 3610 St. James, MO - 655599999 |
Business Phone Number: | 5735782289 |
Business Fax Number: | 5734263076 |
Mailing Address: | 11360 Pvt Dr 5613, ROLLA |
State: | MO |
Postal Code: | 654019808 |
Phone Number: | 5735782289 |
Fax Number: | 5734263076 |
NPI Enumeration Date: | 11/18/2007 |
NPI Last Update Date: | 10/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2007033159 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |