Individual
JACQUELINE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8325 KELWOOD AVE, BATON ROUGE, LA 70806-4804
(225) 239-5498
(225) 239-5543
Mailing address
1340 MONTERREY BLVD, BATON ROUGE, LA 70815-1044
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12456
LA
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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