Individual
MR. MONTRELL DAVID PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLPC, CAADC
Contact information
Practice address
1910 SHAFFER ST, KALAMAZOO, MI 49048-1604
(269) 382-9820
(269) 345-7190
Mailing address
1910 SHAFFER ST, KALAMAZOO, MI 49048-1604
(269) 382-9820
(269) 345-7190
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-03082
MI
101YP2500X
Professional Counselor
Primary
6401013603
MI
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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