Individual
ANTONIO WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3975 UNIVERSITY DR STE 110, FAIRFAX, VA 22030-2520
(540) 845-6940
Mailing address
3975 UNIVERSITY DR STE 110, FAIRFAX, VA 22030-2520
(540) 845-6940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704017287
VA
Other
Enumeration date
02/16/2021
Last updated
10/01/2025
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