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Individual

MS. DA SHAN MONQUIE PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2624 CRIX LN, FORT WORTH, TX 76140-5657
(214) 728-0268
Mailing address
2624 CRIX LN, FORT WORTH, TX 76140-5657
(214) 728-0268

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
04/02/2012
Last updated
04/02/2012
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