DESTINY LEEANNE POTTEBAUM

NEW HAVEN, MO
NPI1255032017
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: FL  ISW16733)
Enumeration Date2023-03-16
Last Update Date2023-03-16
Business Address
DESTINY LEEANNE POTTEBAUM MSW
917 MILLER ST
NEW HAVEN, MO 63068-1192
Phone number: 636-357-0937
Mailing Address
DESTINY LEEANNE POTTEBAUM MSW
917 MILLER ST
NEW HAVEN, MO 63068-1192
Phone number: 636-357-0937
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