Individual
MRS. ELIZABETH AMY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3054 ENTERPRISE DR, STATE COLLEGE, PA 16801-2755
(814) 234-6023
(814) 234-1439
Mailing address
424 WAUPELANI DR APT C13, STATE COLLEGE, PA 16801-4502
(814) 933-6149
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL009073
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023721420001
—
PA
Enumeration date
11/30/2006
Last updated
10/09/2009
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