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Individual

MS. PAMELA LORENE PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
201 N HIGH ST, MUNCIE, IN 47305-1617
(765) 215-0584
Mailing address
PO BOX 48, MUNCIE, IN 47308-0048
(765) 215-0584
(877) 610-3921

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1282264
IN
1041C0700X
Clinical Social Worker
Primary
34003296A
IN

Other

Enumeration date
07/11/2013
Last updated
07/11/2013
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