Individual
ELIZABETH PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
444 EXECUTIVE CENTER BLVD, EL PASO, TX 79902-1058
(915) 600-2796
Mailing address
8655 ADRIANA CT APT 23, EL PASO, TX 79907-6245
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
39407
TX
Other
Enumeration date
05/25/2019
Last updated
05/25/2019
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