Individual
DONNA M POTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5920 BEACONPARK ST, LITHIA, FL 33547-5886
(813) 413-7785
(407) 386-7132
Mailing address
3029 BEAVER POND TRL, VALRICO, FL 33594-7930
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA4830
FL
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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