Individual
JESSICA DANIELLE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
421 W AIRLINE HWY STE F, LA PLACE, LA 70068-3820
(985) 651-4612
Mailing address
139 TAMMY DR, LA PLACE, LA 70068-6474
(985) 817-5309
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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