Individual
JENNIFER MOORE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4992 BRISTOL INDUSTRIAL WAY, BUFORD, GA 30518-1742
(770) 904-6419
(770) 904-6418
Mailing address
4992 BRISTOL INDUSTRIAL WAY, BUFORD, GA 30518-1742
(770) 904-6419
(770) 904-6418
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007334
GA
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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