Doctor Name: | MR. PHILIP RAMON PORTMAN |
NPI Number: | 1578909370 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS |
License Number: | MH11692 |
Business Practice Address: | 116 Hillcrest Rd Adamsville, AL - 350052365 |
Business Phone Number: | 2053705487 |
Business Fax Number: | |
Mailing Address: | 116 Hillcrest Rd, ADAMSVILLE |
State: | AL |
Postal Code: | 350052365 |
Phone Number: | 2053705487 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2013 |
NPI Last Update Date: | 05/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH11692 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |