Individual
DEREK MICHAEL POTTHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1217 HIGHWAY 10 W, ORANGE CITY, IA 51041-1500
(712) 707-9222
Mailing address
1217 HIGHWAY 10 W, ORANGE CITY, IA 51041-1500
(712) 707-9222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
104991
IA
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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