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Individual
JENNIFER M PORTER
Active
Individual
JENNIFER M PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
61850
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197633401
—
TX
01
—
89125L
BCBS
TX
Enumeration date
12/05/2008
Last updated
05/14/2010
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