MEDICARE: HOWARD ALLEN WHITE ED.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6801020431	MI

General Provider Information

NPI Number	:	1104309848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD ALLEN WHITE ED.D

Provider Business Mailing Address
First Line	:	PO BOX 899
Second Line	:
City	:	ORTONVILLE
State	:	MI
Zip	:	48462-0899
Country	:	US
Telephone Number	:	248-634-0446
Fax Number	:	248-634-0446

Provider Business Practice Location Address
First Line	:	8305 GROVELAND RD
Second Line	:
City	:	HOLLY
State	:	MI
Zip	:	48442-9469
Country	:	US
Telephone Number	:	248-634-0446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	09/10/2018

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Directions to “ HOWARD ALLEN WHITE ED.D” Practice Location

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