Individual
JERLYM S PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
262 DANNY THOMAS PL, MS 515, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PL, MS 515, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3008
TN
Other
Enumeration date
04/13/2011
Last updated
04/13/2011
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