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General NPI Number Information
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NPI Number | 1407661267
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Entity Type | Individual
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Provider Name | SHAYLA ELIZABETH POTTS
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 1527 COLLEGE DR
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City | MT. CARMEL
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State | ID
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Zip | 62863
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Country | US
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Telephone | 618-263-6343
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Fax |
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Provider Business Mailing Address
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Address Line | 441 COUNTY ROAD 1225 N
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City | ALBION
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State | IL
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Zip | 62806-4111
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Country | US
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Telephone | 618-302-3079
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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