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General NPI Number Information
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NPI Number | 1982410924
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Entity Type | Individual
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Provider Name | JENNIFER LYNN WHITE LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1011 E PENNSYLVANIA ST
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City | TUCSON
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State | AZ
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Zip | 85714-3310
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Country | US
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Telephone | 520-806-0071
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Fax |
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Provider Business Mailing Address
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Address Line | 17063 S PAINTED VISTAS WAY
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City | VAIL
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State | AZ
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Zip | 85641-2435
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Country | US
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Telephone | 520-468-1327
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | AZ-14022
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License Number State | AZ
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