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Individual

JOANN PORTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3115 SUNSET BLVD, WEST COLUMBIA, SC 29169-3425
(803) 791-3722
Mailing address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 777-9283
(270) 777-9283

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
11/29/2017
Last updated
11/29/2017
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