Individual
DIANA M POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
1740 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-3110
(985) 727-0097
(985) 727-5006
Mailing address
1209 GLENDALE DR, MANDEVILLE, LA 70471-7414
(985) 674-7774
(985) 727-5006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z12494
LA
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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