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General NPI Number Information
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NPI Number | 1982192027
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Entity Type | Individual
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Provider Name | PORCHIA DURANT
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Gender | Female
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 7436 WOODWARD AVE
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City | DETROIT
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State | MI
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Zip | 48202-3100
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Country | US
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Telephone | 248-910-4663
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Fax | 313-633-0585
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Provider Business Mailing Address
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Address Line | 5685 WESTPOINT ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-2351
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Country | US
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Telephone | 248-910-4663
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Fax | 313-633-5085
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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