Provider Demographics
NPI:1437571585
Name:PORTER, HELEN JOSEPHINE (MS MPH RD LD)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:JOSEPHINE
Last Name:PORTER
Suffix:
Gender:F
Credentials:MS MPH RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2225
Mailing Address - Country:US
Mailing Address - Phone:636-394-2632
Mailing Address - Fax:
Practice Address - Street 1:1143 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63011-2225
Practice Address - Country:US
Practice Address - Phone:636-394-2632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001006191133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered