| Lola White Psyd Llc | |
|
388 State St Ste 704 Salem OR 97301-4023 | |
| (503) 917-9623 | |
| Not Available |
| Full Name | Lola White Psyd Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 388 State St Ste 704, Salem, Oregon |
| Authorized Official Name and Position | Laura White (OWNER) |
| Authorized Official Contact | 5039179623 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lola White Psyd Llc 388 State St Ste 704 Salem OR 97301-4023 Ph: (503) 917-9623 | Lola White Psyd Llc 388 State St Ste 704 Salem OR 97301-4023 Ph: (503) 917-9623 |
| NPI Number | 1871114793 |
|---|---|
| Provider Enumeration Date | 05/01/2020 |
| Last Update Date | 05/01/2020 |
| Certification Date | 05/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871114793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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