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NPI Code Detail

MEDICARE: JULIE PORTER LMSW

MEDICARE: JULIE PORTER LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1770002057
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE PORTER LMSW
Provider Business Mailing Address
First Line : 6672 NEWARK RD
Second Line :
City : IMLAY CITY
State : MI
Zip : 48444-9657
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6672 NEWARK RD
Second Line :
City : IMLAY CITY
State : MI
Zip : 48444-9657
Country : US
Telephone Number : 810-724-0591
Fax Number : 810-724-0272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2017
Last Update Date : 09/18/2017

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Directions to “ JULIE PORTER LMSW” Practice Location

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