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Individual

EMMA LORRAINE PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
1011 N GREEN ST, MCHENRY, IL 60050-5720
(779) 244-1000
Mailing address
3912 VALLEY VIEW RD, CRYSTAL LAKE, IL 60012-2104
(815) 271-2574

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
242006477
IL
Enumeration date
05/23/2022
Last updated
06/01/2022
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