Provider Demographics
NPI:1013521061
Name:MCWHITE, DANIEL DUANE
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:DUANE
Last Name:MCWHITE
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 1:1535 BLANDING BLVD APT 120
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-7865
Mailing Address - Country:US
Mailing Address - Phone:904-505-6104
Mailing Address - Fax:
Practice Address - Street 1:1563 KINGSLEY AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4503
Practice Address - Country:US
Practice Address - Phone:904-602-9745
Practice Address - Fax:904-637-4724
Is Sole Proprietor?:No
Enumeration Date:2020-09-06
Last Update Date:2020-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician