Individual
MARY LAUREN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-4969
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-6064
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Enumeration date
05/02/2018
Last updated
11/05/2019
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