Individual
MR. NICHOLAS MICHAEL POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1055 GEZON PKWY SW, GRAND RAPIDS, MI 49509-9542
(616) 773-2908
(616) 532-3046
Mailing address
1055 GEZON PKWY SW, WYOMING, MI 49509-9542
(616) 773-2908
(616) 532-3046
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451023025
MI
106S00000X
Behavior Technician
RBT-17-44099
MI
Other
Enumeration date
12/01/2017
Last updated
05/20/2023
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