Individual
DR. AMANDA COREY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
1400 JEFFERSON RD, NORTHFIELD, MN 55057-3081
(651) 241-0775
(651) 241-0772
Mailing address
1400 JEFFERSON RD, NORTHFIELD, MN 55057-3081
(651) 241-0775
(651) 241-0772
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2007030012
MO
103T00000X
Psychologist
Primary
LP5356
MN
Other
Enumeration date
04/27/2006
Last updated
03/11/2021
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