Individual
CARISSA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-8355
(270) 956-0534
Mailing address
278 ROCKY HOLLOW RD, ERIN, TN 37061-6053
(877) 407-3422
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8187
TN
225X00000X
Occupational Therapist
Primary
OT008832
GA
Other
Enumeration date
05/04/2023
Last updated
05/04/2026
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