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General NPI Number Information
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NPI Number | 1083910509
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Entity Type | Individual
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Provider Name | ALICIA N WHITE BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 2808 HAWKS LANDING BLVD
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City | PANAMA CITY
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State | FL
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Zip | 32405
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Country | US
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Telephone | 615-948-7203
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Fax |
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Provider Business Mailing Address
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Address Line | 1878 E NINE MILE RD APT 1603
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City | PENSACOLA
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State | FL
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Zip | 32514-5413
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Country | US
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Telephone | 850-341-3608
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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 | 246Y00000X
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Taxonomy Name | Health Information Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-15-19917
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License Number State |
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