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Individual

HALEY PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
402 LEGACY PARK DRIVE, RIDGELAND, MS 39157
(769) 233-7154
Mailing address
402B LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
220026
MS
106S00000X
Behavior Technician

Other

Enumeration date
05/13/2021
Last updated
07/18/2022
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