Provider Demographics
NPI:1043085657
Name:PORTER, CHRISTINA ROCHELLE (BS PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROCHELLE
Last Name:PORTER
Suffix:
Gender:F
Credentials:BS PSYCHOLOGY
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5135 CAMINO AL NORTE STE. 112
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031
Mailing Address - Country:US
Mailing Address - Phone:702-405-5423
Mailing Address - Fax:
Practice Address - Street 1:5135 CAMINO AL NORTE STE. 112
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031
Practice Address - Country:US
Practice Address - Phone:702-405-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst