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General NPI Number Information
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NPI Number | 1801790597
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Entity Type | Individual
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Provider Name | BROOKE LYN POTTS M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 454 CONEWANGO AVE
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City | WARREN
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State | PA
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Zip | 16365-1678
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Country | US
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Telephone | 814-723-2872
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Fax | 814-723-2875
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Provider Business Mailing Address
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Address Line | 2389 STANTON HILL RD
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City | RUSSELL
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State | PA
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Zip | 16345-2649
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Country | US
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Telephone | 814-723-2872
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Fax | 814-723-2875
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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 | SL016190
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License Number State | PA
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