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1063628519
SUSAN RENEE PORTER
SAINT LOUIS, MO
NPI
1063628519
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MO 003581)
Enumeration Date
2007-05-14
Last Update Date
2007-07-09
Business Address
-- SUSAN RENEE PORTER M.S.W., L.C.S.W.
4231 SHENANDOAH AVE
SAINT LOUIS, MO 63110-3512
Phone number: 314-517-5644
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Mailing Address
-- SUSAN RENEE PORTER M.S.W., L.C.S.W.
4231 SHENANDOAH AVE
SAINT LOUIS, MO 63110-3512
Phone number: 314-517-5644
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