NPI | 1326372681 |
---|---|
Former Name | CHANDRA L. PORTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: OR 3722) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional (Licence: MT 2180) | |
103T00000X Psychologist (Licence: MT 1047) | |
Enumeration Date | 2009-09-18 |
Last Update Date | 2023-10-20 |