Individual
JENNIFER LEE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, QMHP-A
Contact information
Practice address
304 BURNETTS WAY, SUFFOLK, VA 23434-8048
(757) 641-6357
Mailing address
304 BURNETTS WAY, SUFFOLK, VA 23434-8048
(757) 641-6357
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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