Willie Deeanjlo0 White, LICDC-CS

NPI #1730576091 in London, Ohio

Provider Information

NPI Number
1730576091
Entity Type
Individual
Name
Willie Deeanjlo0 White, LICDC-CS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Substance Abuse Rehabilitation Facility
Credential
LICDC-CS
Enumeration Date
Apr 23, 2015
Last Updated
Apr 27, 2015

Practice Location

Address
1580 STATE ROUTE 56 SW
City
London
State
Ohio
ZIP Code
43140-8623
Phone
(740) 852-2454

Specialties & Taxonomy Codes

Specialty
Substance Abuse Rehabilitation Facility

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