| Issaura Potter, Llc | |
|
175 E 50th St Garden City ID 83714-1413 | |
| (208) 204-0451 | |
| Not Available |
| Full Name | Issaura Potter, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 175 E 50th St, Garden City, Idaho |
| Authorized Official Name and Position | Issa Potter (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2085190901 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Issaura Potter, Llc 2268 S Elderberry Pl Boise ID 83706-4492 Ph: () - | Issaura Potter, Llc 175 E 50th St Garden City ID 83714-1413 Ph: (208) 204-0451 |
| NPI Number | 1235837709 |
|---|---|
| Provider Enumeration Date | 02/23/2023 |
| Last Update Date | 02/23/2023 |
| Certification Date | 02/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235837709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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