Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225C00000X | Rehabilitation Counselor |
NPI | 1265508733 |
---|---|
Provider Name | Mr. Howard Chandler Porter II |
First Address | Paradise, CA 95969-3043 |
Second Address | Paradise, CA 95969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 19/06/2012 |