Provider Demographics
NPI:1720207293
Name:WHITE, CHRISTINE ANNE (BA, BHRS,CMCAF)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNE
Last Name:WHITE
Suffix:
Gender:F
Credentials:BA, BHRS,CMCAF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 E KIRK ST
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:OK
Mailing Address - Zip Code:74743-3637
Mailing Address - Country:US
Mailing Address - Phone:580-326-7531
Mailing Address - Fax:580-326-2733
Practice Address - Street 1:1007 E KIRK ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-3637
Practice Address - Country:US
Practice Address - Phone:580-326-7531
Practice Address - Fax:580-326-2733
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health