Most Relevant Information
Provider Data
| NPI Number: | 1003288242 |
| Provider Name: | KENNER POTTER |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/28/2015 |
| Last Updated: | 10/28/2015 |
Provider Practice Location
9740 S TACOMA WAY
TACOMA
WA
984994456
Practice Location Phone/Fax
| Phone: | 2536520353 |
| Fax: |
Provider Mailing Location
31701 50TH AVE E
EATONVILLE
WA
983289268
Provider Mailing Phone/Fax
| Phone: | 4258916747 |
| Fax: |