Provider Demographics
NPI:1942082391
Name:WHITE, KATILINA LYNN (MS)
Entity Type:Individual
Prefix:
First Name:KATILINA
Middle Name:LYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1171
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-1171
Mailing Address - Country:US
Mailing Address - Phone:602-862-8112
Mailing Address - Fax:
Practice Address - Street 1:65-1190 MAMALAHOA HWY UNIT 9
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8431
Practice Address - Country:US
Practice Address - Phone:602-862-8112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist