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Individual

MS. RENEE L WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1565 NORTHERN AVE, #3, KINGMAN, AZ 86409-2481
(928) 757-8589
(928) 757-0744
Mailing address
1565 NORTHERN AVE, #3, KINGMAN, AZ 86409-2481
(928) 757-8589
(928) 757-0744

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW10131
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
113485
VALUE OPTIONS
AZ
Enumeration date
03/08/2007
Last updated
07/08/2007
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