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Individual

MRS. LISA POTTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8 N CANYON ST, NAMPA, ID 83651-2271
(561) 601-8927
Mailing address
8 N CANYON ST, NAMPA, ID 83651-2271
(561) 601-8927

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
08/25/2022
Last updated
08/25/2022
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