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General NPI Number Information
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NPI Number | 1497100986
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Entity Type | Individual
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Provider Name | MRS. MARLEE ELIZABETH POTTER
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Gender | Female
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Dates
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Enumeration Date | 05/03/2016
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 7700 OAK DR
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City | KEYSTONE HEIGHTS
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State | FL
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Zip | 32656-9723
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Country | US
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Telephone | 904-505-0847
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 OAK DR
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City | KEYSTONE HEIGHTS
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State | FL
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Zip | 32656-9723
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Country | US
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Telephone | 904-505-0847
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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 | SA19525
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 2202012242
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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