Lacey Potter

NPI #1114448917 in Ada, Oklahoma

Provider Information

NPI Number: 1114448917
Entity Type: Individual
Name: Lacey Potter
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Jun 30, 2017
Last Updated: Jun 30, 2017

Practice Location

Address: 15881 COUNTY ROAD 3590
City: Ada
State: Oklahoma
ZIP Code: 74820-0483
Phone: (580) 235-3138

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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