Individual
MAURICE ANTONIO PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3707 E SOUTHERN AVE STE 2054, MESA, AZ 85206-6217
(623) 205-8178
Mailing address
929 N VAL VISTA DR STE 109-1197, GILBERT, AZ 85234-3706
(623) 205-8178
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/10/2024
Last updated
08/10/2024
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