Individual
JACOB VAUGHN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3537 W. FRONT STREET, SUITE F, TRAVERSE CITY, MI 49684
(231) 935-8900
Mailing address
3537 W. FRONT STREET, SUITE F, TRAVERSE CITY, MI 49684
(231) 750-7045
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301018202
MI
Other
Enumeration date
10/11/2018
Last updated
11/05/2019
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