Individual
ELISHIA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1127 N KICKAPOO AVE, SHAWNEE, OK 74801-4845
(405) 214-0116
Mailing address
302 S ELM ST, PADEN, OK 74860-9233
(405) 203-8567
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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