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Individual

MRS. ELANA PORTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
106 OGLETHORPE PROFESSIONAL CT STE A, SAVANNAH, GA 31406-3693
(912) 351-4793
Mailing address
110 ATLAS ST, UNIT #4, SAVANNAH, GA 31405-5477
(201) 874-0420

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
P79173
NY
225XP0200X
Pediatric Occupational Therapist
Primary
OT005296
GA
225XP0200X
Pediatric Occupational Therapist
P79173
NY

Other

Enumeration date
03/29/2011
Last updated
08/26/2011
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