Individual
MR. AUSTIN KENNETH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
957 NATIONAL HWY, LAVALE, MD 21502-7356
(240) 362-7128
Mailing address
957 NATIONAL HWY, LAVALE, MD 21502-7356
(240) 362-7128
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
07755
MD
235Z00000X
Speech-Language Pathologist
SL011607
PA
Other
Enumeration date
03/13/2014
Last updated
08/04/2016
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