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Individual

DONTHAN PORTER JR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5909 VICTORY POINT ST, NORTH LAS VEGAS, NV 89081-3024
(702) 789-8466
Mailing address
4920 SAPPHIRE LIGHT ST, N LAS VEGAS, NV 89081-3036
(702) 809-0576

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/31/2018
Last updated
07/31/2018
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