Individual
AMBERLY PORTERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10611 FLORIDA HIGHWAY 20, BRISTOL, FL 32321
(850) 643-1033
Mailing address
10611 FLORIDA HIGHWAY 20, BRISTOL, FL 32321
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
FL
Enumeration date
03/14/2019
Last updated
06/11/2019
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