Healthcare Provider Details

I. General information

NPI: 1205075694
Provider Name (Legal Business Name): ALESHA D WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W LINN ST
NORMAN OK
73069-5837
US

IV. Provider business mailing address

2429 ARBOR DR
NORMAN OK
73071-2186
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-0022
  • Fax:
Mailing address:
  • Phone: 405-612-6761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: