Provider Demographics
NPI:1013481084
Name:WHITE, NATALIE LOUISE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:LOUISE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 N KALAMAZOO MALL STE 100
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3899
Mailing Address - Country:US
Mailing Address - Phone:269-345-0273
Mailing Address - Fax:269-345-8522
Practice Address - Street 1:2525 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2149
Practice Address - Country:US
Practice Address - Phone:269-823-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker