Individual
SUSAN POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPC-913
Contact information
Practice address
389 ADAMS ST, AFTON, WY 83110-0376
(307) 885-9883
(307) 885-5206
Mailing address
PO BOX 376, AFTON, WY 83110-0376
(307) 885-9883
(307) 885-5206
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PPC-913
WY
171M00000X
Case Manager/Care Coordinator
—
WY
Other
Enumeration date
12/23/2014
Last updated
11/18/2015
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