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Individual

JENNIFER PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MDA, RDN, CD, IBCLC

Contact information

Practice address
1581 E WATERBURY DR UNIT G, SALT LAKE CITY, UT 84121-1134
(208) 286-5415
Mailing address
1581 E WATERBURY DR UNIT G, SALT LAKE CITY, UT 84121-1134
(208) 286-5415

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86083279
UT

Other

Enumeration date
08/05/2025
Last updated
08/05/2025
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