Organization
AUTHENTIC SELF HOLISTIC PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE POTTER LMSW (THERAPIST)
(616) 498-2566
Entity
Organization
Contact information
Practice address
7989 MYERS LAKE AVE NE, ROCKFORD, MI 49341-9634
(616) 498-2566
Mailing address
7989 MYERS LAKE AVE NE, ROCKFORD, MI 49341-9634
(616) 498-2566
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/28/2025
Last updated
03/28/2025
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