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NPI 1851605158

NPI 1851605158 : CHLOE BLAIR WHITE AU.D : DECATUR, GA

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General NPI Number Information
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    NPI Number           |    1851605158
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    Entity Type          |    Individual 
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    Provider Name        |    CHLOE BLAIR WHITE AU.D
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/29/2010
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    Last Update Date     |    01/01/2021
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Provider Practice Location Address
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    Address Line         |    1670 CLAIRMONT RD 
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    City                 |    DECATUR
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    State                |    GA
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    Zip                  |    30033-4004
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    Country              |    US
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    Telephone            |    404-321-6111
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    100 EMANCIPATION DR 
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    City                 |    HAMPTON
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    State                |    VA
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    Zip                  |    23667-0001
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    Country              |    US
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    Telephone            |    757-722-9961
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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        |    231H00000X
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    Taxonomy Name        |    Audiologist
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    License Number       |    147001358
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    License Number State |    IL
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