Individual
MARK ALLEN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1025 MEADOWBROOK AVE, PRAGUE, OK 74864
(405) 380-1135
Mailing address
PO BOX 465, PRAGUE, OK 74864-0465
(405) 567-5542
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3984
OK
Other
Enumeration date
04/03/2008
Last updated
08/12/2009
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