Individual
MRS. CHRISTA L PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
530 ROUTE 6, MAHOPAC, NY 10541-5733
(845) 542-1796
Mailing address
11 SERENITY LN, NEWBURGH, NY 12550-5733
(845) 542-1796
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
004833-1
NY
Other
Enumeration date
11/06/2008
Last updated
11/10/2008
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