Individual
MILLICENT PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3054 JACKSON LIBERTY RD, WESSON, MS 39191-9688
(601) 757-0766
(601) 653-9590
Mailing address
3054 JACKSON LIBERTY ROAD, WESSON, MS 39191
(601) 757-0766
(601) 653-9590
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S4273
MS
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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