Individual
CHEYENNE KILEY PORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 381-9924
Mailing address
283 DUKE ST, EPHRATA, PA 17522-2032
(717) 381-9924
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW022835
PA
Other
Enumeration date
03/27/2023
Last updated
05/10/2023
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