Individual
DR. BENJAMIN PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1400 CARLISLE BLVD NE, SUITE E, ALBUQUERQUE, NM 87110-5658
(505) 255-8890
(505) 266-0541
Mailing address
1400 CARLISLE BLVD NE, SUITE E, ALBUQUERQUE, NM 87110-5658
(505) 255-8890
(505) 266-0541
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
487
NM
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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