Individual
LURA KELLY POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 NE MAPLE ST, PULLMAN, WA 99163-4120
(509) 339-7288
Mailing address
340 NE MAPLE ST, PULLMAN, WA 99163-4120
(509) 334-1133
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MC61276123
WA
103K00000X
Behavior Analyst
Primary
CG1324540
WA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/03/2019
Last updated
05/02/2023
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