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Individual
MS. WADEANA NICOLE PORTER
Active
Individual
MS. WADEANA NICOLE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6700
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142UV
BCBS OF NC
NC
05
—
7412281
—
NC
Enumeration date
08/17/2006
Last updated
07/09/2007
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