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General NPI Number Information
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NPI Number | 1215710470
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Entity Type | Individual
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Provider Name | LAKAYLA WHITE
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Gender | Female
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 3300 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3307
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Country | US
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Telephone | 759-970-3289
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Fax |
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Provider Business Mailing Address
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Address Line | 3508 KINGS CROSS RD
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City | ALEXANDRIA
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State | VA
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Zip | 22303-1016
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Country | US
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Telephone | 703-509-6407
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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