Individual
AVA LOUISE PORTERFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
506 EAST 28TH ST, BRYAN, TX 77803-4029
(979) 224-0832
(979) 450-7896
Mailing address
101 CHESTNUT STREET, SUITE 100, ABILENE, TX 79602
(325) 676-8963
(325) 676-2915
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
14265
TX
101YP2500X
Professional Counselor
14265
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84919L
BCBS OF TX
TX
Enumeration date
08/04/2006
Last updated
05/19/2020
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