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Individual

MRS. JESSICA A POTTORFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, MA, CADC, LMHC

Contact information

Practice address
8450 HICKMAN RD STE 10, CLIVE, IA 50325-4307
(713) 837-6294
(515) 608-4612
Mailing address
8450 HICKMAN RD STE 10, CLIVE, IA 50325-4307
(515) 643-6563
(515) 643-6598

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
115248
IA

Other

Enumeration date
10/23/2018
Last updated
10/07/2024
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