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Individual

MRS. ELLEN NICOLE WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
3900 LLEWELLYN AVE, NORFOLK, VA 23504-1203
(757) 625-5363
Mailing address
6026 DEERFIELD BLVD UNIT 201, MASON, OH 45040-2696
(716) 307-9485

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
14556
OH
235Z00000X
Speech-Language Pathologist
Primary
2202010702
VA

Other

Enumeration date
06/05/2019
Last updated
01/09/2023
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