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Individual

MS. MOLLY B PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS MFT

Contact information

Practice address
2908 FAWNWOOD CIR, VALDOSTA, GA 31602-4100
(229) 560-2117
Mailing address
2908 FAWNWOOD CIR, VALDOSTA, GA 31602-4100
(229) 560-2117

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
12/09/2012
Last updated
12/09/2012
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