Individual
MR. RYAN TROY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1910 S STAPLEY DR STE 209, MESA, AZ 85204-6679
(480) 351-8020
Mailing address
2323 E WILLOW WICK RD, GILBERT, AZ 85296-2723
(847) 971-3579
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
180005697
IL
101YP2500X
Professional Counselor
180005697
IL
101YP2500X
Professional Counselor
Primary
LPC-23103
AZ
Other
Enumeration date
10/03/2007
Last updated
05/14/2025
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