Female

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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