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General NPI Number Information
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NPI Number | 1205988078
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Entity Type | Individual
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Provider Name | MELINDA SHEA WHITE AU.D.FAAA,CCC-A
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1719 RUSSELL PKWY, BLDG CENTRAL GA PROFESSIONAL HEARING
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City | WARNER ROBINS
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State | GA
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Zip | 31088
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Country | US
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Telephone | 478-923-0106
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Fax | 478-922-5211
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Provider Business Mailing Address
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Address Line | 1719 RUSSELL PKWY, BLDG CENTRAL GA PROFESSIONAL HEARING
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City | WARNER ROBINS
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State | GA
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Zip | 31088
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Country | US
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Telephone | 478-923-0106
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Fax | 478-922-5211
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD003181
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License Number State | GA
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