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Individual

GINA M WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
102 FRONT STREET, MINOCQUA, WI 54548
(512) 796-5994
Mailing address
GENERAL DELIVERY, MINOCQUA, WI 54548-9999
(512) 796-5994

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4808
CO

Other

Enumeration date
11/27/2007
Last updated
08/25/2011
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