Provider Demographics
NPI:1588460935
Name:WHITE, KIRA ELOUISE (AUD)
Entity type:Individual
Prefix:DR
First Name:KIRA
Middle Name:ELOUISE
Last Name:WHITE
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 LAKE MARY RD APT 364
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-9253
Mailing Address - Country:US
Mailing Address - Phone:917-937-6040
Mailing Address - Fax:
Practice Address - Street 1:77 W FOREST AVE STE 305
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1481
Practice Address - Country:US
Practice Address - Phone:928-773-2222
Practice Address - Fax:928-773-2287
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA15981231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist