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Individual

GARY MICHAEL WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LGSW

Contact information

Practice address
1322 LOCUST AVE, FAIRMONT, WV 26554-1436
(304) 366-0700
(304) 366-9529
Mailing address
1322 LOCUST AVE, FAIRMONT, WV 26554-1436
(304) 366-0700
(304) 366-9529

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00944697
WV

Other

Enumeration date
03/15/2016
Last updated
03/15/2016
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