Individual
AUDREY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1269 BEACON STREET, BROOKLINE, MA 01760-5248
(617) 512-0191
Mailing address
1269 BEACON ST, BROOKLINE, MA 02446-5248
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/10/2010
Last updated
06/10/2010
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