Individual
DR. KELLY D WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
18475 ROBSON ST, DETROIT, MI 48235-2863
(313) 270-4615
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
71007047
IL
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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