Individual
DR. CHARLA JEANINE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9625 SURVEYOR CT, SUITE 200, MANASSAS, VA 20110-4422
(703) 330-9933
(703) 368-8454
Mailing address
2997 STOCKHOLM WAY, WOODBRIDGE, VA 22191-4286
(703) 680-5146
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003345
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0515622
—
VA
Enumeration date
03/01/2006
Last updated
08/18/2009
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