Individual
KEYONA NICHOLE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
16 BUSHROD CT, CHARLES TOWN, WV 25414-4430
(703) 554-9047
Mailing address
16 BUSHROD CT, CHARLES TOWN, WV 25414-4430
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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