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General NPI Number Information
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NPI Number | 1417947045
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Entity Type | Individual
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Provider Name | NANCY DUTTON POTTER PHD
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Gender | Female
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 205 HIRST RD
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City | PURCELLVILLE
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State | VA
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Zip | 20132-6198
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Country | US
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Telephone | 703-674-8929
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Fax |
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Provider Business Mailing Address
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Address Line | 205 HIRST RD STE 103
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City | PURCELLVILLE
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State | VA
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Zip | 20132-6199
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Country | US
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Telephone | 703-674-8929
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1081
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License Number State | VA
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