Individual
JEREMY L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 N BEHREND AVE, FARMINGTON, NM 87401-8414
(505) 330-8220
(505) 234-7867
Mailing address
101 E BROADWAY AVE, BLOOMFIELD, NM 87413-6235
(505) 330-8220
(505) 234-7867
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NM
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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