Provider Information for 1043959844
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SHAWANA PORTER MA, LPC
Sex: Female
NPI: 1043959844
Last Updated: 2025-02-25
Certification Date: 2025-02-25
Certification Date: 2025-02-25
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1043959844 | ||||||||
| Enumeration Date | 2022-05-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 625 MIDDLEBERG WAY FLORENCE, SC 29505-3641 United States Phone: 803-513-2909 | Fax: | ||||||||
| Primary Practice Address | 625 MIDDLEBERG WAY FLORENCE, SC 29505-3641 United States Phone: 803-513-2909 | Fax: | ||||||||
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