Individual
MISS ALYSSA JANE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, LAC
Contact information
Practice address
3310 E DOUGLAS AVE, WICHITA, KS 67208
(316) 617-9831
Mailing address
3310 E DOUGLAS AVE, WICHITA, KS 67208-3314
(316) 617-9831
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
167
KS
1041C0700X
Clinical Social Worker
Primary
4792
KS
Other
Enumeration date
09/08/2011
Last updated
05/24/2018
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