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Individual
JACKIE L POTTS
Active
Individual
JACKIE L POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SLP004960
GA
235Z00000X
Speech-Language Pathologist
Primary
SP0000001594
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4000592
BCBST
TN
05
—
4000592
—
TN
01
—
4640001
UNITEDHEALTHCARE
TN
Enumeration date
07/31/2006
Last updated
07/09/2007
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