Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | LP5849 | MN |
Y | 103TC0700X | Clinical Psychologist | LP5849 | MN |
NPI | 1003252842 |
---|---|
Provider Name | Dr. Kristi E. White |
First Address | Minneapolis, MN 55406-1963 |
Second Address | Minneapolis, MN 55406-1963 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 09/11/2015 |