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Individual
GINA PORTER
Active
Individual
GINA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225X00000X
Occupational Therapist
Primary
0119005958
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0279
LICENSE#
AL
01
—
K949 - 0055
CAREFIRST
VA
Enumeration date
01/09/2007
Last updated
01/21/2019
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