Individual
MELLENIE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
T-LMHC
Contact information
Practice address
702 MAIN ST, TABOR, IA 51653-2067
(712) 629-1069
Mailing address
702 MAIN ST, TABOR, IA 51653-2067
(712) 629-1069
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
139399
IA
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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