ETHAN POTTER

SPRINGFIELD, MO
NPI1275188799
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MO  2021024924)
Additional Taxonomies1041C0700X Social Worker, Clinical
Enumeration Date2019-08-02
Last Update Date2024-06-27
Business Address
ETHAN POTTER LCSW
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804-1513
Phone number: 417-224-7806
Mailing Address
ETHAN POTTER LCSW
2135 E INDEPENDENCE ST # 1033
SPRINGFIELD, MO 65804-3749
Phone number: 417-224-7806