Individual
MRS. JEAN ELAYNE PORTERFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
71 CLINTON RD, GARDEN CITY, NY 11530-4742
(516) 396-2500
Mailing address
121 PARK AVE, RONKONKOMA, NY 11779-1729
(631) 648-3965
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
621143951
NY
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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