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General NPI Number Information
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NPI Number | 1275402067
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Entity Type | Individual
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Provider Name | MEGAN PORTER
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Gender |
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 3518 LACLEDE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63103-2011
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Country | US
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Telephone | 314-977-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 105 AUTUMN DR
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City | SIKESTON
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State | MO
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Zip | 63801-5124
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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