Basic Information
| Provider Information | |||||||||
| NPI: | 1891125571 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHITE-SPUNNER | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | RACHEL | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 372 GREENO RD S | ||||||||
| Address2: | |||||||||
| City: | FAIRHOPE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365321916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2519282871 | ||||||||
| FaxNumber: | 2519904186 | ||||||||
| Practice Location | |||||||||
| Address1: | 709 W 14TH ST | ||||||||
| Address2: | |||||||||
| City: | BAY MINETTE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365073305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2519371784 | ||||||||
| FaxNumber: | 2519376010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2013 | ||||||||
| LastUpdateDate: | 11/18/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.