Organization
DAVID M PORTNER, PH.D. PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MICHAEL PORTNER PH.D. (OWNER)
(757) 642-2567
Entity
Organization
Contact information
Practice address
1428 WATER MILL CIR, VIRGINIA BEACH, VA 23454-1359
(757) 642-2567
(757) 233-0201
Mailing address
1428 WATER MILL CIR, VIRGINIA BEACH, VA 23454-1359
(757) 642-2567
(757) 233-0201
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001188
VA
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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