Organization
SEVEN COUNTIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANIQUA L. POTTER (PRINCIPAL CASE MANAGER)
(502) 419-5466
Entity
Organization
Contact information
Practice address
8202 VERMISSA CT, APT. 4, LOUISVILLE, KY 40222-3790
(502) 419-5466
Mailing address
8202 VERMISSA CT, APT. 4, LOUISVILLE, KY 40222-3790
(502) 419-5466
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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