Individual
BRENNAN PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC-IT
Contact information
Practice address
1268 W MAIN ST, SUN PRAIRIE, WI 53590-1930
(608) 834-1122
Mailing address
1268 W MAIN ST, SUN PRAIRIE, WI 53590-1930
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4795-226
WI
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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