Organization
ALYSSA PORTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ALYSSA JANE PORTER LSCSW, LMAC (THERAPIT/PROVIDER)
(316) 617-9831
Entity
Organization
Contact information
Practice address
3310 E DOUGLAS AVE, WICHITA, KS 67208-3314
(316) 617-9831
Mailing address
3310 E DOUGLAS AVE, WICHITA, KS 67208-3314
(316) 617-9831
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4792
KS
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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