White, Willie

White, Willie is an individual health care provider with primary practice located at 620 S Laurel St , Pine Bluff AR 71601-4859. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. White, Willie can be contacted via phone (870) 534-4900.

Contact Information

Primary practice address
620 S Laurel St Pine Bluff AR 71601-4859
Phone: (870) 534-4900
Fax: (870) 534-4906
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1013313303
LBN Legal business name White, Willie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2014
Last updated Nov 13th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013313303 NPPES
Arkansas MEDICAID 180635526

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