Individual
MS. ELLEN RAE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HS
Contact information
Practice address
118 UNION ST, CLARKSVILLE, TN 37040-5115
(931) 647-8257
(931) 647-2987
Mailing address
342 GREENLEAF LN, CLARKSVILLE, TN 37040-4367
(931) 206-2362
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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