Healthcare Provider Details

I. General information

NPI: 1154796860
Provider Name (Legal Business Name): WENDESIA WHITE PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNITED STATES ARMY HEALTH CLINIC GRAFENWOEHR UNIT 28130, PSC 415
APO AA
09114-0034
US

IV. Provider business mailing address

WALTER REED NATIONAL MILITARY MEDICAL CENTER
APO AA
20889
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-3102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4634
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: