Individual provider · NPI-1

Ebony Delshun Porter

Occupational Therapist · Mt Juliet, TN

NPI number1467672816
StatusActive
Last updated in NPPESAug 14, 2025

Details

NPI
1467672816
Entity type
Individual (NPI-1)
Name
Mrs. Ebony Delshun Porter
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 26, 2007
Certification date
Aug 14, 2025
Last updated
Aug 14, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist4379TNYes
253Z00000X In Home Supportive Care––

Practice location

126 Paddock Place Dr
Mt Juliet, TN 37122-6605

Phone 214-364-6155

Mailing address

Po Box 523
Mount Juliet, TN 37121-0523

Phone 214-364-6155

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