Individual
JO A WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1166 LEMMON LN # 7323, ELLIJAY, GA 30540-6480
(770) 712-6662
Mailing address
1166 LEMMON LN # 7323, ELLIJAY, GA 30540-6480
(770) 712-6662
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/27/2015
Last updated
11/27/2015
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