Individual
JAIME L PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
1921 N MARKET ST, MONTICELLO, IL 61856-8144
(217) 762-5371
(217) 762-4066
Mailing address
1921 N MARKET ST, MONTICELLO, IL 61856-8144
(217) 762-5371
(217) 762-4066
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.010478
IL
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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