Individual
BRENT WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1450 MAIN STREET, WEAVERVILLE, CA 96093
(530) 623-1362
Mailing address
PO BOX 1640, WEAVERVILLE, CA 96093-1640
(530) 623-1362
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MFTI68822
CA
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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