Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH3151546 | OH |
NPI | 1023412764 |
---|---|
Provider Name | Chelsa Porter |
First Address | Mc Arthur, OH 45651-1093 |
Second Address | Mc Arthur, OH 45651-1093 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2014 |
Last Update Date | 09/10/2014 |