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1104419886
DEREK POTTER
INDIANAPOLIS, IN
NPI
1104419886
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: IN RBT-21-152377)
Enumeration Date
2021-02-14
Last Update Date
2021-02-14
Business Address
DEREK POTTER
8350 CRAIG ST
INDIANAPOLIS, IN 46250-3593
Phone number: 317-578-0410
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Mailing Address
DEREK POTTER
2323 COYNER AVE
INDIANAPOLIS, IN 46218-4331
Phone number: 973-641-2634
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