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General NPI Number Information
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NPI Number | 1104263383
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Entity Type | Individual
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Provider Name | COURTNEY WHITE IBCLC, CLE, CIMI
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Gender | Female
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 139 OAKBROOK DR
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City | COPPELL
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State | TX
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Zip | 75019-4033
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Country | US
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Telephone | 469-569-9917
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Fax |
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Provider Business Mailing Address
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Address Line | 179 HIGHLAND MEADOW CIR
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City | COPPELL
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State | TX
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Zip | 75019-5736
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Country | US
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Telephone | 469-569-9917
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | 11093949
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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