Provider Demographics
NPI:1689480709
Name:WHITE, RHONDA GAIL (ALC)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:GAIL
Last Name:WHITE
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8658 COUNTY ROAD 636
Mailing Address - Street 2:
Mailing Address - City:CHANCELLOR
Mailing Address - State:AL
Mailing Address - Zip Code:36316-7090
Mailing Address - Country:US
Mailing Address - Phone:334-806-1591
Mailing Address - Fax:
Practice Address - Street 1:557 GLOVER AVE STE 3
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2070
Practice Address - Country:US
Practice Address - Phone:334-308-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional