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Individual

HAILIE PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
6060 DIXIE HWY STE H, CLARKSTON, MI 48346-3476
(248) 455-6619
Mailing address
334 ORCHARD ST, GRAND BLANC, MI 48439-3312
(248) 763-3523

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801117894
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1335
MI
Enumeration date
06/03/2020
Last updated
10/10/2025
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