Provider Demographics
NPI:1548074610
Name:WHITE, CHRISTIN ELAINE
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:ELAINE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6757 HERRIMAN HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-8964
Mailing Address - Country:US
Mailing Address - Phone:801-709-1762
Mailing Address - Fax:
Practice Address - Street 1:8156 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-6468
Practice Address - Country:US
Practice Address - Phone:801-944-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health