Individual
EMIRY POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCMHC, LADC
Contact information
Practice address
2 CHURCH ST, 4A, BURLINGTON, VT 05401-4299
(802) 598-8343
Mailing address
2 CHURCH ST, BURLINGTON, VT 05401-4299
(802) 598-8343
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000611
VT
101YM0800X
Mental Health Counselor
Primary
068.0104208
VT
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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