Individual
PHYLLIS HEATH WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
717 S 7TH AVE, BROKEN BOW, NE 68822-2521
(308) 872-2742
Mailing address
80259 LILLIAN RD, BROKEN BOW, NE 68822-5507
(308) 872-2742
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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