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Individual

DR. DAVID MICHAEL PORTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
1428 WATER MILL CIR, VIRGINIA BEACH, VA 23454-1359
(757) 642-2567
(757) 233-0201
Mailing address
1428 WATER MILL CIR, VIRGINIA BEACH, VA 23454-1359
(757) 642-2567
(757) 233-0201

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001188
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007704224
VA
05
007704232
VA
05
007705557
VA
Enumeration date
09/20/2006
Last updated
07/11/2010
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