Individual
MR. WAYNE SCOTT PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW; APSW
Contact information
Practice address
3900 W BROWN DEER RD, BROWN DEER, WI 53209-1220
(414) 540-2170
Mailing address
2658 N 56TH ST, MILWAUKEE, WI 53210-2235
(414) 873-2979
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
104100000
WI
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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