Individual
GERALDINE PORTERFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2540 WOODROW WILSON BLVD APT 8, WEST BLOOMFIELD, MI 48324-1723
(248) 631-8517
Mailing address
PO BOX 250131, WEST BLOOMFIELD, MI 48325-0131
(248) 631-8517
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
02/09/2018
Last updated
04/05/2018
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