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Individual

CHARLOTTE-ANE POTTER WILLEKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
40 BEACON ST E, LACONIA, NH 03246-3437
(603) 524-1100
Mailing address
40 BEACON ST E, LACONIA, NH 03246-3437
(603) 524-1100

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7706646Y0NH01
ANTHEM
NH
01
889986A
MVP HEALTHCARE
NH
Enumeration date
01/30/2007
Last updated
11/12/2024
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