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General NPI Number Information
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NPI Number | 1265210140
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Entity Type | Individual
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Provider Name | MS. JOAN WHITE
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Gender | Female
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 4219 CAMERON RD
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City | HOPEWELL
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State | VA
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Zip | 23860-1690
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Country | US
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Telephone | 804-704-9931
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Fax |
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Provider Business Mailing Address
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Address Line | 11533 BUSY ST STE 207
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-4073
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Country | US
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Telephone | 804-704-9931
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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