Individual
MS. CAROL POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
2200 HUNT ST, DETROIT, MI 48207-5605
(248) 537-2516
Mailing address
2200 HUNT ST, DETROIT, MI 48207-5605
(248) 537-2516
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003073099
—
MI
01
—
1841905551
GROUP NPI
—
Enumeration date
05/19/2008
Last updated
03/04/2024
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