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General NPI Number Information
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NPI Number | 1902618366
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Entity Type | Individual
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Provider Name | CHRISTINA M. POTTERS MSW
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Gender | Female
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 125 S SWOOPE AVE STE 110
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City | MAITLAND
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State | FL
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Zip | 32751-5784
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Country | US
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Telephone | 407-622-0444
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Fax | 407-699-0444
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Provider Business Mailing Address
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Address Line | 1588 W POWDER HORN RD
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City | TITUSVILLE
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State | FL
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Zip | 32796-1561
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Country | US
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Telephone | 321-616-3744
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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