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Individual

MARK G WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
15 KANOA ST, HILO, HI 96720-2426
(808) 430-3111
Mailing address
15 KANOA ST, HILO, HI 96720-2426
(808) 430-3111

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
496
HI

Other

Enumeration date
10/18/2010
Last updated
01/07/2022
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