Individual
BONITA NICOLE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
707 E 47TH ST, CHICAGO, IL 60653-4201
(312) 949-5554
Mailing address
707 E 47TH ST, CHICAGO, IL 60653-4201
(312) 949-5554
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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