Individual
DR. ATHENA MARIE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
29764 HIGHWAY 21, ANGIE, LA 70426-3069
(985) 986-0016
(985) 986-1260
Mailing address
7100 S SOUTH SHORE DR, 611, CHICAGO, IL 60649-2700
(773) 978-1070
(708) 660-0776
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
LA
Enumeration date
09/16/2006
Last updated
07/08/2007
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