Doctor Name: | MS. WENDY ELISE PORTER |
NPI Number: | 1043495625 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.A.D.C |
License Number: | 0614 |
Business Practice Address: | 56 Circle Dr Meredith, NH - 032536304 |
Business Phone Number: | 6034555203 |
Business Fax Number: | |
Mailing Address: | 56 Circle Dr, MEREDITH |
State: | NH |
Postal Code: | 032536304 |
Phone Number: | 6034555203 |
Fax Number: | |
NPI Enumeration Date: | 01/02/2008 |
NPI Last Update Date: | 01/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 0614 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |