Provider Demographics
NPI:1942897160
Name:WHITE, ZPHORE CLAYON
Entity Type:Individual
Prefix:
First Name:ZPHORE
Middle Name:CLAYON
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 1:5451 MILLENIA LAKES BLVD APT 209
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6309
Mailing Address - Country:US
Mailing Address - Phone:347-972-3971
Mailing Address - Fax:
Practice Address - Street 1:5451 MILLENIA LAKES BLVD APT 209
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-6309
Practice Address - Country:US
Practice Address - Phone:347-972-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical