| NPI | 1679977706 |
|---|---|
| Former Name | MADALYN KAYE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC60490762) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG60481649) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |