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General NPI Number Information
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NPI Number | 1073169405
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Entity Type | Individual
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Provider Name | KAYLA BROOKE WHITE M.A. LPC-R
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Gender | Female
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 08/12/2019
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Provider Practice Location Address
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Address Line | 950 N WASHINGTON ST STE 322
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City | ALEXANDRIA
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State | VA
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Zip | 22314-1534
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Country | US
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Telephone | 757-653-1352
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 N PIERCE ST APT 603
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City | ARLINGTON
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State | VA
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Zip | 22209-3412
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Country | US
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Telephone | 757-653-1352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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