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General NPI Number Information
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NPI Number | 1659318012
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Entity Type | Organization
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Legal Business Name | SANDRA WHITE
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 09/30/2008
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Provider Practice Location Address
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Address Line | 3301 N 3RD ST SUITE 140
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City | ABILENE
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State | TX
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Zip | 79603-7054
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Country | US
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Telephone | 325-675-5990
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Fax | 325-673-9414
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Provider Business Mailing Address
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Address Line | 3301 N 3RD ST STE 140
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City | ABILENE
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State | TX
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Zip | 79603-7054
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Country | US
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Telephone | 325-675-5990
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Fax | 325-673-9414
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | SANDRA WHITE
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Credential |
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Telephone | 325-675-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11870
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License Number State | TX
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