Individual
AMY JEAN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP/L
Contact information
Practice address
505 S CHERRY ST, O FALLON, IL 62269-2043
(618) 632-3621
Mailing address
737 KLEIN DR, SMITHTON, IL 62285-1403
(518) 830-9528
(618) 443-2892
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/16/2017
Last updated
09/29/2022
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