Provider Demographics
NPI:1285002832
Name:WHITE, EDWARD
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-7818
Mailing Address - Country:US
Mailing Address - Phone:775-348-8811
Mailing Address - Fax:775-313-9759
Practice Address - Street 1:525 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-7818
Practice Address - Country:US
Practice Address - Phone:775-348-8811
Practice Address - Fax:775-313-9759
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor