Provider Demographics
NPI:1528126356
Name:WHITE, THELMA D (PHD)
Entity type:Individual
Prefix:DR
First Name:THELMA
Middle Name:D
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6649 N HIGH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4004
Mailing Address - Country:US
Mailing Address - Phone:614-888-7211
Mailing Address - Fax:614-888-3246
Practice Address - Street 1:6649 N HIGH ST STE 106
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4004
Practice Address - Country:US
Practice Address - Phone:614-888-7211
Practice Address - Fax:614-888-3246
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1065103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist