Individual
DERRICK ALLEN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1441 E 84TH PL, MERRILLVILLE, IN 46410-6451
(219) 794-2000
(219) 794-2010
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1928
(219) 757-1950
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006954A
IN
Other
Enumeration date
11/03/2011
Last updated
04/17/2014
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