Individual
JACKIE L WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, PC
Contact information
Practice address
817 KILBOURNE ST, BELLEVUE, OH 44811-9431
(419) 483-9411
Mailing address
PO BOX 202, BELLEVUE, OH 44811-0202
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1100556
OH
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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