Individual
RITA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
407 KENSINGTON DR, HATTIESBURG, MS 39402-1941
(601) 705-1901
Mailing address
407 KENSINGTON DR, HATTIESBURG, MS 39402-1941
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
34566
MS
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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