Amy Porter LPC, CSAC
Professional Counselor in Jefferson, WI(View on Map)
Full Name
Amy Porter LPC, CSAC
NPI Number
1295132702
NPI Type
Individual Provider
Gender
Female
Enumeration Date
11/26/2014
Specialties
(Taxonomies)Code
101YP2500X
101YA0400X
Primary Taxonomy
Yes
No
Licenses
State
Wisconsin
License Number
6292-125
Contact
Information
Purpose
Mailing
Location
Address
1541 ANNEX RD
1541 ANNEX RD
City
Jefferson
Jefferson
State
WI
WI
Postal Code
53549-9803
53549-9803
Country
US
US
Telephone Number
(920) 674-3105
(920) 674-3105
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/08/2023
Provider Address
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