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General NPI Number Information
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NPI Number | 1841943966
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Entity Type | Individual
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Provider Name | PATRICIA WHITE
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Gender | Female
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 3520 OAKS WAY APT 904
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City | POMPANO BEACH
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State | FL
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Zip | 33069-5387
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Country | US
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Telephone | 305-807-0308
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Fax |
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Provider Business Mailing Address
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Address Line | 6251 PALM TRACE LANDINGS DR APT 109
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City | DAVIE
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State | FL
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Zip | 33314-1882
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Country | US
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Telephone | 910-853-5321
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 103K00000K
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License Number State | FL
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