Individual provider · Type 1 NPI

Mallory Potter, BS LADC

Addiction (Substance Use Disorder) Counselor · Minneapolis, MN

NPI number 1891102836 Active

Practice location

3329 University Ave SE
Minneapolis, MN 55414-3325

Call (612) 454-2297 Map

Fax (612) 252-0308

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X303687 (MN)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1891102836

Mallory Potter, BS LADC's National Provider Identifier is 1891102836, issued on Jul 22, 2014. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Minneapolis, MN. The record was last updated on Jul 22, 2014.