Individual
MR. DAN KENNETH PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW, LICDC
Contact information
Practice address
8445 MUNSON RD, MENTOR, OH 44060-2410
(440) 255-1700
(440) 205-2417
Mailing address
9007 OLD STATE RD, CHARDON, OH 44024-9255
(440) 286-7191
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I3749
OH
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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