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Individual

COLLEEN PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3065 COLLEGE RD, FAIRBANKS, AK 99709-3702
(907) 374-1686
Mailing address
3065 COLLEGE RD, FAIRBANKS, AK 99709-3702
(907) 374-1686

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
016594-1
NY
225X00000X
Occupational Therapist
0720134454
VT
225X00000X
Occupational Therapist
Primary
222699
AK

Other

Enumeration date
11/28/2012
Last updated
08/22/2024
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