Individual
DR. TARRELL L PORTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
361 EAST FIRST STREET, RIVERSIDE, IA 52327-9688
(319) 648-2648
Mailing address
361 EAST FIRST STREET, RIVERSIDE, IA 52327-9688
(319) 648-2648
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00729
IA
101YP2500X
Professional Counselor
001247
MO
Other
Enumeration date
10/18/2012
Last updated
10/19/2012
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