Individual
MRS. ALISSA ANN POTOCNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
10000 W. 75TH ST., SUITE 25, QUANTUM HEALTH PROFESSIONALS, MERRIAM, KS 66204
(913) 894-1910
Mailing address
1137 NE OAK TREE DR, LEES SUMMIT, MO 64086-3143
(816) 246-9435
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
115036
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115036
STATE LICENSE NUMBER
MO
Enumeration date
09/19/2008
Last updated
09/19/2008
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