Individual
DWIGHT A PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4405 MALL BLVD, SUITE 200, UNION CITY, GA 30291-2044
(770) 969-4309
(770) 969-4170
Mailing address
4405 MALL BLVD, SUITE 200, UNION CITY, GA 30291-2044
(770) 969-4309
(770) 969-4170
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
006366
GA
Other
Enumeration date
08/13/2013
Last updated
08/13/2013
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