Individual
BRIAN POTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, CSAC, BCBA
Contact information
Practice address
4029 DEAN MARTIN DR, LAS VEGAS, NV 89103-4138
(702) 848-2256
Mailing address
279 LINCOLN STREET, HAHNEMANN FAMILY HEALTH CENTER, UMASS MEMORIAL MEDICAL CENTER, WORCESTER, MA 01605-1736
(508) 334-8830
(508) 334-8810
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0858
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740610278
—
NV
Enumeration date
11/19/2013
Last updated
03/22/2019
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