Individual
GINA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS, OTR/L
Contact information
Practice address
817 CRAWFORD AVE, AUGUSTA, GA 30904-3772
(706) 736-1255
(706) 736-1258
Mailing address
432 RICHMOND ST, EVANS, GA 30809-5478
(706) 496-5786
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005787
GA
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003140054A
—
GA
Enumeration date
10/29/2013
Last updated
08/23/2021
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