Provider Demographics
NPI:1073733440
Name:PORTER, RACHEL (MSW)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 COMMERCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6574
Mailing Address - Country:US
Mailing Address - Phone:248-470-7663
Mailing Address - Fax:313-535-5266
Practice Address - Street 1:25945 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-1808
Practice Address - Country:US
Practice Address - Phone:313-535-6560
Practice Address - Fax:313-535-5266
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical