Individual
BRIAN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
55 ELM ST, GLENS FALLS, NY 12801-3549
(518) 793-7273
(518) 798-5004
Mailing address
PO BOX 417153, BOSTON, MA 02241-7153
(518) 952-8140
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29051
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03008326
—
NY
Enumeration date
01/09/2014
Last updated
01/09/2014
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