Individual
DR. STACY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 BURNET AVE, ML 3015, CINCINNATI, OH 45229
(513) 636-4336
(513) 636-7756
Mailing address
3333 BURNET AVE, ML 3015, CINCINNATI, OH 45229
(513) 636-4336
(513) 636-7756
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
P.08208
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
09/19/2018
Last updated
11/17/2022
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