ASHANTI IDA POTTER

ROSEBURG, OR
NPI1174116552
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2021-02-16
Last Update Date2026-02-12
Business Address
Ms. ASHANTI IDA POTTER
2575 NW KLINE ST.
ROSEBURG, OR 97471
Phone number: 541-673-3504
Mailing Address
Ms. ASHANTI IDA POTTER
2575 NW KLINE ST
ROSEBURG, OR 97471-8827
Phone number: 541-673-3504