Doctor Name: | ELIZABETH PORFERT |
NPI Number: | 1013395326 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | IMH |
License Number: | IMH13464 |
Business Practice Address: | 10033 Winding River Rd Punta Gorda, FL - 339501302 |
Business Phone Number: | 2392847164 |
Business Fax Number: | |
Mailing Address: | 10033 Winding River Rd, PUNTA GORDA |
State: | FL |
Postal Code: | 339501302 |
Phone Number: | 2392847164 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2015 |
NPI Last Update Date: | 05/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | IMH13464 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |