Individual
MS. IVY MICHELLE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
935 MARIETTA ST NW APT 417, ATLANTA, GA 30318-0534
(470) 219-1561
Mailing address
935 MARIETTA ST NW APT 417, ATLANTA, GA 30318-0534
(470) 219-1561
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008321
GA
Other
Enumeration date
09/18/2013
Last updated
01/31/2020
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