Individual
MARY SUSAN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1798 HEWITT AVE, SAINT PAUL, MN 55104-1129
(612) 240-5459
Mailing address
4501 45TH AVE S, MINNEAPOLIS, MN 55406-4026
(612) 240-5459
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC00397
MN
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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