Individual
MR. LANE CANNON PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
2973 W 13800 S, BLUFFDALE, UT 84065-8202
(801) 577-4804
(844) 965-9279
Mailing address
473 E CAROLINE DAY CV, DRAPER, UT 84020-5164
(801) 577-4804
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7960484-6004
UT
Other
Enumeration date
10/28/2010
Last updated
02/11/2021
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