Individual
MISS KASSANDRA DENAY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
640 GRASSMERE PARK STE 116, NASHVILLE, TN 37211-3678
(615) 866-8922
Mailing address
120 BRENTRIDGE DR # 120, ANTIOCH, TN 37013-3737
(662) 274-8686
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/21/2022
Last updated
03/11/2022
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