Healthcare Provider Details

I. General information

NPI: 1487586566
Provider Name (Legal Business Name): SYDNEY ANNE WHITE M. ED, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 AIRPORT DR STE D
COLUMBUS OH
43219-2284
US

IV. Provider business mailing address

1301 CLUBVIEW BLVD S
COLUMBUS OH
43235-1633
US

V. Phone/Fax

Practice location:
  • Phone: 614-741-6261
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90316
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: