Individual
JESSICA POTEAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 7TH ST, RACINE, WI 53403, RACINE, WI 53403-1222
(262) 634-2391
Mailing address
420 7TH ST, RACINE, WI 53403, RACINE, WI 53403-1222
(262) 634-2391
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17188-130
WI
101YP2500X
Professional Counselor
Primary
2264-226
WI
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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