Individual
MS. JENNIFER T PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
109 DEERFIELD RD, GUNTOWN, MS 38849-7975
(662) 891-7567
Mailing address
109 DEERFIELD RD, GUNTOWN, MS 38849-7975
(662) 401-9034
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C4775
MS
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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