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1003926098
JESSICA BROOKE PORTER
WATERFORD, MI
NPI
1003926098
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
Miss JESSICA BROOKE PORTER B.S, FAODP
1435 N OAKLAND BLVD
WATERFORD, MI 48327-1549
Phone number: 248-666-2720
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Mailing Address
Miss JESSICA BROOKE PORTER B.S, FAODP
1147 IRONWOOD CT APT 004
ROCHESTER, MI 48307-1261
Phone number: 248-909-0189
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