Individual
KRISTEN KAY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSP
Contact information
Practice address
600 LOUISA AVE, DUPO, IL 62239-1469
(618) 286-3214
Mailing address
600 LOUISA AVE, DUPO, IL 62239-1469
(618) 286-3214
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2439989
IL
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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