Individual
STEVEN MARK PORTNOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
19875 BUTTERNUT LN, SOUTHFIELD, MI 48076-1795
(248) 568-3711
(248) 569-9410
Mailing address
30200 TELEGRAPH RD, SUITE 207, BINGHAM FARMS, MI 48025-4502
(248) 568-3711
(248) 569-9410
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007087
MI
103TS0200X
School Psychologist
6301007087
MI
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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