Provider Demographics
NPI:1891010450
Name:ALLIE-TURCO, PORTIA XOLISWA
Entity Type:Individual
Prefix:MRS
First Name:PORTIA
Middle Name:XOLISWA
Last Name:ALLIE-TURCO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:PORTIA
Other - Middle Name:XOLISWA
Other - Last Name:ALLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:16 CROSS RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:NY
Mailing Address - Zip Code:12936-1918
Mailing Address - Country:US
Mailing Address - Phone:518-963-7122
Mailing Address - Fax:
Practice Address - Street 1:16 CROSS RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:NY
Practice Address - Zip Code:12936-1918
Practice Address - Country:US
Practice Address - Phone:518-963-7122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health