Provider Demographics
NPI:1275585176
Name:WHITE, LINNEA CAROL (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINNEA
Middle Name:CAROL
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16720 275TH ST
Mailing Address - Street 2:
Mailing Address - City:TREYNOR
Mailing Address - State:IA
Mailing Address - Zip Code:51575-7587
Mailing Address - Country:US
Mailing Address - Phone:712-487-3062
Mailing Address - Fax:712-487-3475
Practice Address - Street 1:16720 275TH ST
Practice Address - Street 2:
Practice Address - City:TREYNOR
Practice Address - State:IA
Practice Address - Zip Code:51575-7587
Practice Address - Country:US
Practice Address - Phone:712-487-3062
Practice Address - Fax:712-487-3475
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA396103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling