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1841774205
KELLY PORTER
DETROIT, MI
NPI
1841774205
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-09-21
Last Update Date
2018-09-21
Business Address
KELLY PORTER
9605 GRAND RIVER AVE
DETROIT, MI 48204-2139
Phone number: 313-834-5930
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Mailing Address
KELLY PORTER
9605 GRAND RIVER AVE
DETROIT, MI 48204-2139
Phone number: 313-834-5930
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