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1003952912
NATHAN R PORTER
IDAHO FALLS, ID
NPI
1003952912
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-27844)
Enumeration Date
2007-01-29
Last Update Date
2016-06-30
Business Address
Mr. NATHAN R PORTER LCSW
100 N WOODRUFF AVE
IDAHO FALLS, ID 83401-4335
Phone number: 208-346-2363
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Mailing Address
Mr. NATHAN R PORTER LCSW
100 N WOODRUFF AVE
IDAHO FALLS, ID 83401-4335
Phone number: 208-386-2363
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