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Misty Porter
Peer Specialist in Idaho Falls, Idaho
NPI 1235905274

Misty Porter is a Peer Specialist based in Idaho Falls, ID. Misty Porter practices in Idaho Falls, ID. The NPI Number for Misty Porter is 1235905274 and holds a License No. (Idaho).

The current practice location address for Misty Porter is 540 3Rd St, Idaho Falls, ID and can be reached out via phone at 208-524-5607 and via fax at 208-524-0636.

Location: 540 3Rd St, Idaho Falls, ID, 83401-3953
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1235905274
Provider Name
Misty Porter
Credential
Provider Entity Type
Individual
Gender
Female
Address
540 3Rd St, Idaho Falls, ID, 83401-3953
Phone Number
208-524-5607
Fax Number
208-524-0636
Provider Enumeration Date
11/30/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
540 3Rd St
City
Idaho Falls
State
Idaho
Zip
83401-3953
Phone Number
208-524-5607
Fax Number
208-524-0636
person
Provider Business Mailing Address Details
Address
540 3Rd St
City
Idaho Falls
State
Idaho
Zip
83401-3953
Phone Number
208-524-5607
Fax Number
208-524-0636
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Idaho)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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