Individual
MS. ELIZABETH ANN PORTEUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
5313 PALEO PINES CIR, FORT PIERCE, FL 34951-2344
(772) 577-3158
Mailing address
5313 PALEO PINES CIR, FORT PIERCE, FL 34951-2344
(772) 577-3158
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
05704
MD
235Z00000X
Speech-Language Pathologist
Primary
SA11437
FL
235Z00000X
Speech-Language Pathologist
SL010271
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039935300
—
MD
05
—
1025554100001
—
PA
05
—
105167500
—
FL
Enumeration date
01/08/2011
Last updated
02/10/2022
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