Provider Demographics
NPI:1457072290
Name:WHITE, CHRISTIANA JOY (RBT)
Entity type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:JOY
Last Name:WHITE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BLUEGRASS LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-8137
Mailing Address - Country:US
Mailing Address - Phone:706-248-7449
Mailing Address - Fax:
Practice Address - Street 1:1 BLUEGRASS LN
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-8137
Practice Address - Country:US
Practice Address - Phone:706-248-7449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-22-215792106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician