Individual
REBECCA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1110 GRAND AVE, ASBURY PARK, NJ 07712-6012
(732) 775-0720
Mailing address
300 4TH AVE, ASBURY PARK, NJ 07712-6006
(732) 775-0720
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
44SL07198000
NJ
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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