person
Ms. Ashanti Ida Potter
Addiction (Substance Use Disorder) Counselor in Roseburg, Oregon
NPI 1174116552

Ashanti Ida Potter is an Addiction (Substance Use Disorder) Counselor based in Myrtle Creek, OR and is specialized in Addiction (Substance Use Disorder). Ashanti Ida Potter practices in Roseburg, OR. The NPI Number for Ashanti Ida Potter is 1174116552 and holds a License No. (Oregon).

The current practice location address for Ashanti Ida Potter is 2575 Nw Kline St., Roseburg, OR and can be reached out via phone at 541-673-3504.

Location: 2575 Nw Kline St., Roseburg, OR, 97457
person
Provider Profile Details
NPI Number
1174116552
Provider Name
Ashanti Ida Potter
Credential
Provider Entity Type
Individual
Gender
Female
Address
2575 Nw Kline St., Roseburg, OR, 97457
Phone Number
541-673-3504
Fax Number
Provider Enumeration Date
02/16/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
RG600X5Y 05 OR
institution
Provider Business Practice Location Address Details
Address
2575 Nw Kline St.
City
State
Zip
97471
Phone Number
541-673-3504
Fax Number
person
Provider Business Mailing Address Details
Address
2575 Nw Kline St.
City
State
Zip
97471
Phone Number
541-673-3504
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
(Oregon)
Definition
Definition to come...
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