Individual
MS. SANDRA KAYE POTTORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
600 CAISSON HILL ROAD, IRWIN ARMY HOSPITAL, FT. RILEY, KS 66442
(785) 239-7291
Mailing address
3120 HERITAGE LN, APARTMENT 169, MANHATTAN, KS 66503-2259
(785) 537-8815
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3546
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3546
LICENSE NUMBER
KS
Enumeration date
09/14/2006
Last updated
07/08/2007
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