Provider Demographics
NPI:1003943887
Name:WHITE, YVETTE RENEE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:RENEE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3647 BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3678
Mailing Address - Country:US
Mailing Address - Phone:317-989-2229
Mailing Address - Fax:317-871-2867
Practice Address - Street 1:3647 BRANCH WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3678
Practice Address - Country:US
Practice Address - Phone:317-989-2229
Practice Address - Fax:317-871-2867
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002982A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist