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Organization
WHITE INDUSTRIES, LLC
Active
Organization
WHITE INDUSTRIES, LLC
Active
Other names
Back 2 Basics Behavior Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA N WHITE BCBA (OWNER/OPERATOR)
(615) 948-7203
Entity
Organization
Contact information
Practice address
2808 HAWKS LANDING BLVD, PANAMA CITY, FL 32405-6659
(615) 948-7203
Mailing address
2808 HAWKS LANDING BLVD, PANAMA CITY, FL 32405-6659
(615) 948-7203
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017740500
—
FL
Enumeration date
06/15/2018
Last updated
06/15/2018
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