Provider Demographics
NPI:1124541313
Name:WHITE, CHRISENIA MARIA (ND,LDN, LAC, DC)
Entity type:Individual
Prefix:DR
First Name:CHRISENIA
Middle Name:MARIA
Last Name:WHITE
Suffix:
Gender:F
Credentials:ND,LDN, LAC, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24558 TRIBE SQ APT 101
Mailing Address - Street 2:
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2650
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10560 MAIN ST STE 510
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7173
Practice Address - Country:US
Practice Address - Phone:571-934-1726
Practice Address - Fax:800-963-5633
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.007151133N00000X, 133NN1002X
VA0121-000942171100000X
DCND2200098175F00000X
VA0104-557598111N00000X
DCNP-0098175F00000X
IL038013231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
472557822OtherN/A