Individual
MRS. KIM MARIE POTVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LADC
Contact information
Practice address
215 N MAIN ST, MAILBOX 116E, WHITE RIVER JUNCTION, VT 05009-0001
(802) 295-9363
(802) 296-6389
Mailing address
18 BANK AVE, CLAREMONT, NH 03743-2218
(802) 295-9363
(802) 296-6389
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
000356
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000356
LICENSED ALCOHOL AND DRUG
VT
Enumeration date
08/30/2006
Last updated
07/08/2007
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