Individual
RENIQUE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
501 BAXTER AVE, LOUISVILLE, KY 40204-1103
(502) 821-3431
Mailing address
714 MALONE PL, LOUISVILLE, KY 40245-4132
(502) 821-3431
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6921
KY
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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