Individual
MR. LUCAS RAMON PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A,, L.P.A.
Contact information
Practice address
1100 WALNUT ST, OWENSBORO, KY 42301-2956
(270) 684-2692
Mailing address
1100 WALNUT ST, OWENSBORO, KY 42301-2956
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSYPAT00225290
KY
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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