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Individual

ANGEL NICOLE PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LCMHC

Contact information

Practice address
2920 FORESTVILLE RD STE 100-1212, RALEIGH, NC 27616-8774
(910) 939-1025
Mailing address
4944 BROWN DR, KAILUA, HI 96734-6259
(910) 939-1025

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13428
NC
101YP2500X
Professional Counselor
13428
NC

Other

Enumeration date
10/24/2017
Last updated
11/03/2021
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