Individual
KELLEY PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
23 WATER ST STE 3, SACO, ME 04072-5119
(207) 939-8566
Mailing address
23 WATER ST STE 3, SACO, ME 04072-5119
(207) 939-8566
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MC14851
ME
1041C0700X
Clinical Social Worker
Primary
LC16215
ME
Other
Enumeration date
08/04/2014
Last updated
10/21/2019
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