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General NPI Number Information
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NPI Number | 1689489072
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Entity Type | Individual
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Provider Name | LANEEN S WHITE MS ED
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 23472 JOHN CANE RD
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City | GREENBUSH
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State | VA
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Zip | 23357-2242
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Country | US
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Telephone | 757-709-5229
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Fax |
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Provider Business Mailing Address
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Address Line | 821 WHITE OAKS LN
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City | POCOMOKE CITY
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State | MD
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Zip | 21851-9589
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Country | US
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Telephone | 757-709-5229
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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 | 0704014863
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License Number State | VA
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