Individual
JEAN TAYLOR. PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1021 MINDEN LN, DESOTO, TX 75115-7429
(214) 597-9298
Mailing address
1021 MINDEN LN, DESOTO, TX 75115-7429
(214) 597-9298
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
07012
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SW00S41G2
—
TX
Enumeration date
12/28/2007
Last updated
12/28/2007
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