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Individual

ROY WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
3 CLEARVIEW CIR, MOSELLE, MS 39459-9520
(601) 544-1499
(601) 544-8464
Mailing address
3 CLEARVIEW CIR, MOSELLE, MS 39459-9520
(601) 544-1499
(601) 544-8464

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
51 884
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201742
BLUE CROSS BLUE SHIELD
KS
Enumeration date
06/12/2006
Last updated
10/07/2011
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