Individual
GLENN P ORTENZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 E SIX FORKS RD STE 117, RALEIGH, NC 27609-7753
(919) 833-8899
Mailing address
211 E SIX FORKS RD STE 117, RALEIGH, NC 27609-7753
(919) 833-8899
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2588
NC
Other
Enumeration date
05/13/2011
Last updated
05/13/2011
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