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Individual

REBECCA DENISE WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPRC, CPSS, CPRC SUP

Contact information

Practice address
492 WAYNE AVE, POCATELLO, ID 83201-4541
(208) 206-2285
Mailing address
2154 E 1340 S, HEBER CITY, UT 84032-1248
(208) 505-9990

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
ID

Other

Enumeration date
09/09/2022
Last updated
09/09/2022
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