Porter, Christian Wayne

Porter, Christian Wayne is an individual health care provider with primary practice located at 322 Dupont Dr Ste C , Seymour IN 47274-1764. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Porter, Christian Wayne can be contacted via phone (317) 334-7331.

Contact Information

Primary practice address
322 Dupont Dr Ste C Seymour IN 47274-1764
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-19-401227 Indiana

Profile Details

NPI number 1194364778
LBN Legal business name Porter, Christian Wayne
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 31st, 2019
Last updated Jul 7th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194364778 NPPES
Indiana MEDICAID 300033976

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