Individual
MR. WAYNE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 PETERBORO ST, DETROIT, MI 48201-2722
(313) 831-3160
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9099
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
43
MI
175T00000X
Peer Specialist
Primary
—
MI
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/25/2016
Last updated
03/25/2024
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