Provider Demographics
NPI:1033102470
Name:PORTER, VALENTIN DANIELLE (ATC)
Entity type:Individual
Prefix:MS
First Name:VALENTIN
Middle Name:DANIELLE
Last Name:PORTER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 MAIN ST
Mailing Address - Street 2:#4
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 MAIN ST
Practice Address - Street 2:#4
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4143
Practice Address - Country:US
Practice Address - Phone:301-938-2807
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer