Individual
ANGELA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5524
Mailing address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5524
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
GA
Enumeration date
07/11/2016
Last updated
08/16/2019
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