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General NPI Number Information
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NPI Number | 1396545331
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Entity Type | Individual
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Provider Name | ANTRIEL PORTER
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 34 SHERMAN AVE
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City | PATERSON
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State | NJ
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Zip | 07502-2305
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Country | US
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Telephone | 862-287-5670
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Fax |
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Provider Business Mailing Address
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Address Line | 88 SANDY CT
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City | PATERSON
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State | NJ
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Zip | 07522-2006
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Country | US
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Telephone | 862-336-2339
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Fax | 862-336-2339
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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