National Provider Identifier

Fallon Rae Potter

Fallon Rae Potter is listed in the NPPES registry with a primary specialty of Counselor in North Collins, NY and a listed phone number of (716) 796-3416.

NPI 1841924297North Collins, NYCounselor

Profile Overview

NPI
1841924297
Provider Type
Individual
Primary Specialty
Counselor
Enumeration Date
July 12, 2022
Last Updated
July 12, 2022

Practice Location

  • 2101 Spruce St
  • North Collins, NY 14111-9701

Phone: (716) 796-3416

Specialties

  • Counselor (101Y00000X)
Full Record
NPI
1841924297
Entity Type
Individual
Last Name
Potter
First Name
Fallon
Middle Name
Rae
Mailing Street Address
2101 Spruce St
Mailing City
North Collins
Mailing State
NY
Mailing ZIP Code
14111-9701
Mailing Country
US
Mailing Phone
(716) 796-3416
Mailing Fax
(716) 337-2723
Practice Street Address
2101 Spruce St
Practice City
North Collins
Practice State
NY
Practice ZIP Code
14111-9701
Practice Country
US
Practice Phone
(716) 796-3416
Practice Fax
(716) 337-2723
Enumeration Date
July 12, 2022
Last Updated
July 12, 2022
Sex
Female
Sole Proprietor
No
Certification Date
July 12, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Counselor (101Y00000X)