| Doctor Name: | REBECCA L PORTA |
| NPI Number: | 1225072986 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | SW 5144 |
| Business Practice Address: | 1680 Hartwick Pines Rd Grayling, MI - 497389237 |
| Business Phone Number: | 9893442002 |
| Business Fax Number: | |
| Mailing Address: | 7680 Timberline Road Ne, KALKASKA |
| State: | MI |
| Postal Code: | 49646 |
| Phone Number: | 3214415735 |
| Fax Number: | |
| NPI Enumeration Date: | 06/15/2006 |
| NPI Last Update Date: | 12/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW 5144 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |