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Individual

DENNIS WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICDC-CS

Contact information

Practice address
246 NORTHLAND DRIVE SUITE 200A, MEDINA, OH 44256-3440
(330) 725-9195
(330) 725-9187
Mailing address
246 NORTHLAND DRIVE SUITE 200A, MEDINA, OH 44256-3440
(330) 725-9195
(330) 725-9187

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ICDC.976187-CS
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ICDC.976187-CS
LICENSE NUMBER
OH
Enumeration date
06/27/2016
Last updated
06/27/2016
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