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Individual

DR. GWINNE WYATT PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
667 STONELEIGH AVE, SUITE 202, CARMEL, NY 10512-2454
(917) 747-4218
Mailing address
667 STONELEIGH AVE, SUITE 202, CARMEL, NY 10512-2454
(917) 747-4218

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
016716
NY

Other

Enumeration date
11/13/2006
Last updated
12/19/2014
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