Individual
DR. HEATHER E POTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
945 S 4TH ST APT 5, SPRINGFIELD, IL 62703-2864
(703) 728-7004
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
11200
MA
103TH0100X
Health Service Psychologist
—
—
Other
Enumeration date
08/12/2019
Last updated
11/19/2019
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