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1326792946
JACOB PORTER
MINNEAPOLIS, MN
NPI
1326792946
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MN 28211)
Enumeration Date
2022-02-11
Last Update Date
2022-02-11
Business Address
JACOB PORTER LICSW
2312 S 6TH ST
MINNEAPOLIS, MN 55454-1336
Phone number: 612-672-6999
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Mailing Address
JACOB PORTER LICSW
2641 34TH AVE S
MINNEAPOLIS, MN 55406-1735
Phone number: 319-415-5464
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