Individual
DIAMOND WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 LORRAINE AVE APT 3B, MOUNT VERNON, NY 10553-1254
(914) 327-6042
Mailing address
40 LORRAINE AVE, MOUNT VERNON, NY 10553-1252
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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