Individual
MRS. SUSAN PORCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
608 FRANQUETTE ST, MEDFORD, OR 97501-7832
(541) 858-1793
(541) 858-1793
Mailing address
PO BOX 1345, ROGUE RIVER, OR 97537-1345
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11302
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240357
—
OR
Enumeration date
01/29/2007
Last updated
07/08/2007
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