Individual
MRS. PORTIA MBAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4108 MULBERRY DR, CARROLLTON, TX 75010-1058
(469) 767-1870
Mailing address
4108 MULBERRY DR, CARROLLTON, TX 75010-1058
(469) 999-7368
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
1005797
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/24/2008
Last updated
04/22/2022
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