Provider Demographics
NPI:1669232377
Name:LARKEY, KATIE POTTER
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:POTTER
Last Name:LARKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PINE CONE TRL
Mailing Address - Street 2:
Mailing Address - City:UNICOI
Mailing Address - State:TN
Mailing Address - Zip Code:37692-4956
Mailing Address - Country:US
Mailing Address - Phone:423-724-7759
Mailing Address - Fax:423-205-5706
Practice Address - Street 1:3692 W MARKET ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-9302
Practice Address - Country:US
Practice Address - Phone:423-724-7759
Practice Address - Fax:423-205-5706
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8312235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist