Individual
MRS. SUSAN PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MC, LPC
Contact information
Practice address
5570 W MINE TRL, PHOENIX, AZ 85083-9326
(623) 826-5980
(623) 486-8963
Mailing address
5570 W MINE TRL, PHOENIX, AZ 85083-9326
(623) 826-5980
(623) 486-8963
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC14112
AZ
Other
Enumeration date
06/28/2010
Last updated
01/22/2013
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