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Organization
RYAN T PORTER
Active
Organization
RYAN T PORTER
Active
Other names
Guardian Lighthouse, LTD
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN T PORTER LCPC (OWNERE)
(847) 971-3579
Entity
Organization
Contact information
Practice address
150 E COOK AVE, SUITE 105, LIBERTYVILLE, IL 60048-2060
(847) 971-3579
Mailing address
513 DEER CROSSING CT, HAINESVILLE, IL 60030-3855
(847) 971-3579
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180005697
IL
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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