# GINA PORTER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1043369440
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | 0119005958 | VA | Yes |

## Other

- **Enumeration date:** 01/09/2007
- **Last updated:** 01/21/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0279 | LICENSE\# | AL |
| 01 | — | K949 - 0055 | CAREFIRST | VA |