Individual
MR. ANDREW PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
16301 SONOMA PARK DR, EDMOND, OK 73013-2091
(572) 208-8425
Mailing address
1800 NW 122ND STREET, OKLAHOMA CITY, OK 73120-9524
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
3875
OK
Other
Enumeration date
05/04/2007
Last updated
03/24/2023
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