Most Relevant Information
Provider Data
| NPI Number: | 1003019746 |
| Provider Name: | KRISTINE POTTER SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 923 |
Most Important Dates
| Enumeration Date: | 06/08/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
141 MARKET PL
SUITE 203
FAIRVIEW HEIGHTS
IL
622082034
Practice Location Phone/Fax
| Phone: | 6183984118 |
| Fax: | 8478819640 |
Provider Mailing Location
141 MARKET PL
SUITE 203
FAIRVIEW HEIGHTS
IL
622082034
Provider Mailing Phone/Fax
| Phone: | 6183984118 |
| Fax: | 8478819640 |