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General NPI Number Information
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NPI Number | 1952293920
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Entity Type | Individual
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Provider Name | PATRICIA PORTER
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Gender | Female
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 5930 MAHOOD DR
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City | HUNTINGTON
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State | WV
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Zip | 25705-2210
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Country | US
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Telephone | 304-955-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 7611 PATRICK RD
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City | ASHLAND
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State | KY
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Zip | 41102-9065
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Country | US
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Telephone | 304-638-9902
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | BP00947072
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License Number State | WV
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