Individual
ANN M PORTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1524 ATWOOD AVE, SUITE 213, JOHNSTON, RI 02919-3228
(401) 351-0400
(401) 351-0410
Mailing address
75 NEWMAN AVE, SUITE 100, RUMFORD, RI 02916-3606
(401) 453-0666
(401) 453-9619
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS00486
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204670
BLUE CHIP PROVIDER #
RI
01
—
30232-0
BLUE SHIELD PROVIDER #
RI
Enumeration date
09/06/2006
Last updated
10/20/2011
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