Quaniesha Porter, IDD WAIVER SERVICES
NPI #1508582552 in Leakesville, Mississippi
Provider Information
- NPI Number
- 1508582552
- Entity Type
- Individual
- Name
- Quaniesha Porter, IDD WAIVER SERVICES
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Day Training/Habilitation Specialist
- Credential
- IDD WAIVER SERVICES
- Enumeration Date
- Oct 12, 2022
- Last Updated
- Oct 12, 2022
Practice Location
- Address
- 710 OAK ST
- City
- Leakesville
- State
- Mississippi
- ZIP Code
- 39451-3127
- Phone
- (601) 394-2887
Specialties & Taxonomy Codes
| Specialty |
|---|
| Day Training/Habilitation Specialist |
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