Individual
WILLIE DEEANJLO0 WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICDC-CS
Contact information
Practice address
1580 STATE ROUTE 56 SW, LONDON, OH 43140-8623
(740) 852-2454
Mailing address
770 W BROAD ST, COLUMBUS, OH 43222-1419
(614) 752-1290
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/23/2015
Last updated
04/27/2015
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