Individual
MARY ANNA CAROL PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.HT.
Contact information
Practice address
122 KETCHUM WAY, MADISON, AL 35758-1033
(256) 668-2830
Mailing address
122 KETCHUM WAY, MADISON, AL 35758-1033
(256) 668-2830
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
010519
CA
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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