Organization
ISSAURA POTTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISSA POTTER LPC (LICENSED PROFESSIONAL COUNSELOR)
(208) 519-0901
Entity
Organization
Contact information
Practice address
175 E 50TH ST, GARDEN CITY, ID 83714-1413
(208) 204-0451
Mailing address
2268 S ELDERBERRY PL, BOISE, ID 83706-4492
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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