Individual
DONNA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
706 GOODYEAR BLVD, PICAYUNE, MS 39466-3220
(601) 798-3230
Mailing address
706 GOODYEAR BLVD, PICAYUNE, MS 39466-3220
(601) 798-3230
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
01002363
MS
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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