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Individual

JARVARA WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17410 MACK AVE # 1045, GROSSE POINTE, MI 48230-6228
(313) 443-5919
Mailing address
15564 LINCOLN AVE, EASTPOINTE, MI 48021-2918
(313) 443-5919

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
MI
246QL0900X
Laboratory Management Specialist/Technologist
MI
246RM2200X
Medical Laboratory Technician
MI
246RP1900X
Phlebotomy Technician
Primary
MI
247ZC0005X
Clinical Laboratory Director (Non-physician)
MI
305S00000X
Point of Service
MI
310400000X
Assisted Living Facility
AS820380700
MI

Other

Enumeration date
09/23/2016
Last updated
10/27/2025
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