Individual
MS. HEATHER LYNN KINKADE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
515 STERNBERG AVE, USAMEDDAC, FAMILY ADVOCACY PROGRAM, FORT EUSTIS, VA 23604-1526
(757) 314-7966
Mailing address
PO BOX 7, BENA, VA 23018-0007
(804) 815-3166
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006168
VA
Other
Enumeration date
07/31/2008
Last updated
04/15/2009
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