Individual
MRS. BRITTANI AMBER MARIE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LADC
Contact information
Practice address
5563 HUGO RD, WHITE BEAR LAKE, MN 55110-2344
(651) 465-5036
Mailing address
5563 HUGO RD, WHITE BEAR LAKE, MN 55110-2344
(651) 468-5036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
300933
MN
101YM0800X
Mental Health Counselor
Primary
CC02078
MN
Other
Enumeration date
04/21/2010
Last updated
05/31/2019
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