Kevin Lynn White Jr.
Counselor, Professional in Wentzville, MO. Individual provider (NPI-1).
NPI number1982169199
StatusActive
Last updated in NPPESFeb 1, 2019
Details
- NPI
- 1982169199
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kevin Lynn White Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 1, 2019
- Last updated
- Feb 1, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 2004037122 | MO | Yes |
Practice location
500 Medical DrWentzville, MO 63385-3421
Phone 314-344-6700 · Fax 314-344-6194
Mailing address
500 Medical DrWentzville, MO 63385-3421
Phone 314-344-6700 · Fax 314-344-6194
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