Individual
DR. NICHOLAS PORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
2514 1/2 WESLEY ST STE 2, JOHNSON CITY, TN 37601-1754
(423) 529-0385
(423) 414-2699
Mailing address
2514 1/2 WESLEY ST STE 2, JOHNSON CITY, TN 37601-1754
(423) 529-0385
(423) 414-2699
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2015033025
MO
103T00000X
Psychologist
Primary
P0000003473
TN
Other
Enumeration date
09/25/2015
Last updated
03/21/2018
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