Individual
MRS. AMANDA POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
6747 WISE AVE, SAINT LOUIS, MO 63139-3727
(618) 973-9779
Mailing address
6747 WISE AVE, SAINT LOUIS, MO 63139-3727
(618) 973-9779
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2011008939
MO
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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