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Individual

JESSICA L PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
1848 REISTERSTOWN RD STE A, PIKESVILLE, MD 21208-1379
(443) 360-5527
(877) 353-0384
Mailing address
6202 GIST AVE, BALTIMORE, MD 21215-3608
(443) 360-5527
(877) 353-0384

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10183
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10183
MARYLAND SLP LICENSE #
MD
Enumeration date
06/03/2022
Last updated
06/03/2022
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