Individual
TINA M WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
41 MAPLE ST, NEW GLOUCESTER, ME 04260-4428
(207) 926-4349
Mailing address
41 MAPLE ST, NEW GLOUCESTER, ME 04260-4428
(207) 926-4349
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230510000
—
ME
Enumeration date
10/29/2009
Last updated
10/29/2009
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