LAURA GUSTAFSON PORTER

POWELL, TN
NPI1720087901
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: TN  P2546)
Additional Taxonomies103TC0700X Psychologist, Clinical
(Licence: TN  2546(provisional))
Enumeration Date2005-07-19
Last Update Date2017-11-30
Business Address
LAURA GUSTAFSON PORTER PhD
7714 CONNER RD STE 105
POWELL, TN 37849-3559
Phone number: 865-947-6220
Mailing Address
LAURA GUSTAFSON PORTER PhD
6350 W ANDREW JOHNSON HWY DEPT 100
TALBOTT, TN 37877-8605
Phone number: 800-355-3565