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 Date2021-02-16
Business Address
Ms. ASHANTI IDA POTTER
2575 NW KLINE ST.
ROSEBURG, OR 97471
Phone number: 541-673-3504
Mailing Address
Ms. ASHANTI IDA POTTER
P.O. BOX 1722
MYRTLE CREEK, OR 97457
Phone number: 541-733-8899
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