Provider Demographics
NPI:1134108095
Name:WHITE, ELAINE (MS)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:MARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:789 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2526
Mailing Address - Country:US
Mailing Address - Phone:603-516-0092
Mailing Address - Fax:603-516-0093
Practice Address - Street 1:15 OLD ROLLINSFORD ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2870
Practice Address - Country:US
Practice Address - Phone:603-516-0092
Practice Address - Fax:603-516-0093
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS