Individual
ALICIA PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2377 MARKET DR, FLEMING ISLAND, FL 32003-4326
(904) 579-4779
Mailing address
2644 SUNRISE VILLAGE DR UNIT A, ORANGE PARK, FL 32065-7694
(978) 552-8322
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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