Individual
MALISA D WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1531 WELLINGTON AVE, INDIANAPOLIS, IN 46219-3844
(317) 414-6294
Mailing address
1531 WELLINGTON AVE, INDIANAPOLIS, IN 46219-3844
(317) 414-6294
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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