Provider Demographics
NPI:1851563696
Name:POTTER, PATRICIA CALDWELL (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:CALDWELL
Last Name:POTTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 W END AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2612
Mailing Address - Country:US
Mailing Address - Phone:615-320-1155
Mailing Address - Fax:
Practice Address - Street 1:1720 W END AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2612
Practice Address - Country:US
Practice Address - Phone:615-320-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002782103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical