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Individual

MS. ELIZABETH ROSE WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
21 TOTMAN ST, FLOOR 2, QUINCY, MA 02169
(617) 698-0770
Mailing address
36 RIDGE RD, MILTON, MA 02186
(617) 698-0770

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LICSW10334
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008084
VALU OPTION
01
42431
HARVARD PILGRIM
01
722930
TUFTS HEALTH PO
01
P02053
BLUE CROSS
Enumeration date
07/27/2006
Last updated
07/08/2007
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