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1659318012

NPI Code Detail

MEDICARE: SANDRA WHITE

MEDICARE: SANDRA WHITE

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	101YP2500X	Professional Counselor	11870	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659318012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDRA WHITE

Provider Business Mailing Address
First Line	:	3301 N 3RD ST STE 140
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79603-7054
Country	:	US
Telephone Number	:	325-675-5990
Fax Number	:	325-673-9414

Provider Business Practice Location Address
First Line	:	3301 N 3RD ST
Second Line	:	SUITE 140
City	:	ABILENE
State	:	TX
Zip	:	79603-7054
Country	:	US
Telephone Number	:	325-675-5990
Fax Number	:	325-673-9414

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	SANDRA WHITE
Credential	:
Telephone Number	:	325-675-5990

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	09/30/2008

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Directions to “SANDRA WHITE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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