Provider Demographics
NPI:1932243565
Name:WHITE MCCLANAHAN, PATRICIA DIANNE (PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DIANNE
Last Name:WHITE MCCLANAHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:DIANNE
Other - Last Name:FINCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8476 U S HWY 231 ADMH DIVISION OF INTELLECTUAL DISABILI
Mailing Address - Street 2:COMPREHENSIVE SUPPORT SVCS RIV & V
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092
Mailing Address - Country:US
Mailing Address - Phone:334-514-4268
Mailing Address - Fax:
Practice Address - Street 1:8476 U S HWY 231 ADMH DIVISION OF INTELLECTUAL DISABILI
Practice Address - Street 2:COMPREHENSIVE SUPPORT SVCS RIV & V
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092
Practice Address - Country:US
Practice Address - Phone:334-514-4268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2404103TC0700X
ALPENDING103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPENDINGOtherLICENSED PSYCHOLOGIST
NC2404OtherPSYCHOLOGICAL ASSOCIATE