Individual
SHANNON LOUISE SEXTON POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
58 POMFRET ST, PUTNAM, CT 06260-1888
(603) 315-0525
Mailing address
31 CANTERBURY RD, BROOKLYN, CT 06234-1901
(603) 315-0525
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
29011535
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29011535
CT
CT
01
—
MT01810
LICENSE
RI
Enumeration date
07/25/2013
Last updated
10/27/2025
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