Individual
JACQUELINE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9224 ASHCROFT LN, TWINSBURG, OH 44087-2532
(216) 217-2004
Mailing address
9224 ASHCROFT LN, TWINSBURG, OH 44087-2532
(216) 217-2004
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
372600000X
Adult Companion
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2162172004
—
OH
Enumeration date
11/08/2022
Last updated
11/08/2022
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