Individual
NEISHA POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1120 BECK AVE, CODY, WY 82414-3624
(307) 578-7601
Mailing address
1120 BECK AVE, CODY, WY 82414-3624
(307) 578-7601
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1090
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143514100
—
WY
Enumeration date
04/13/2016
Last updated
06/14/2021
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