Individual
MS. GINA BOOTH PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW,PIP
Contact information
Practice address
2701 WOODVIEW DR SE, HUNTSVILLE, AL 35801-2830
(256) 998-0879
Mailing address
2701 WOODVIEW DR SE, HUNTSVILLE, AL 35801-2830
(256) 998-0879
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2178C
AL
Other
Enumeration date
06/11/2009
Last updated
06/11/2009
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