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General NPI Number Information
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NPI Number | 1710796842
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Entity Type | Individual
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Provider Name | LEAH PORTER
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 3644 OBERLIN AVE
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City | LORAIN
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State | OH
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Zip | 44053-2760
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Country | US
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Telephone | 440-252-1383
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Fax |
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Provider Business Mailing Address
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Address Line | 16201 RAYMOND ST
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City | MAPLE HEIGHTS
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State | OH
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Zip | 44137-2820
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Country | US
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Telephone | 216-758-1660
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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