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General NPI Number Information
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NPI Number | 1609631902
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Entity Type | Individual
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Provider Name | GINA WHITE
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Gender | Female
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 13837 LANYARD WAY
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City | WINTER GARDEN
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State | FL
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Zip | 34787-8643
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Country | US
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Telephone | 815-988-1504
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Fax |
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Provider Business Mailing Address
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Address Line | 13837 LANYARD WAY
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City | WINTER GARDEN
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State | FL
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Zip | 34787-8643
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Country | US
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Telephone | 815-988-1504
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1944644
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 606316H
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 567799
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1092984
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License Number State | FL
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