Individual
MR. MICHAEL ALLEN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPC, LAC
Contact information
Practice address
18301 N 79TH AVE STE F168, GLENDALE, AZ 85308-6045
(602) 633-2246
Mailing address
7357 W CAMERON DR, PEORIA, AZ 85345-8792
(623) 866-9717
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAC-18117
AZ
101YP2500X
Professional Counselor
Primary
LAC-18117
AZ
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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