Individual
MARK WHITE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
322 ELTON HILLS DR NW, ROCHESTER, MN 55901-2476
(507) 226-0002
(507) 226-0003
Mailing address
25094 600TH AVE, BROWNSDALE, MN 55918-8502
(507) 259-8107
(507) 266-0003
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
903
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136742
UCARE
MN
01
—
497S2FA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
05/10/2006
Last updated
07/08/2007
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