Individual
MAYA DANIELLE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 YOUREE DR, SHREVEPORT, LA 71101-5117
(318) 675-0804
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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