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Individual

MRS. JENNIFER L. WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
801 5TH AVE SE, DEVILS LAKE, ND 58301-3649
(701) 662-2769
(701) 662-7684
Mailing address
801 5TH AVE SE, DEVILS LAKE, ND 58301-3649
(701) 662-2769
(701) 662-7684

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1058
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
55578
ND
Enumeration date
01/21/2010
Last updated
01/21/2010
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