Individual
AMBER POORTENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14813 101ST AVENUE, DYER, IN 46311
(219) 245-7970
Mailing address
17506 CLINE ST, LOWELL, IN 46356-2257
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/03/2025
Last updated
12/03/2025
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