Provider Demographics
NPI:1912601246
Name:POTVIN, NATALIE K (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:K
Last Name:POTVIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:K
Other - Last Name:KARPOWICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43 MAYFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-1913
Mailing Address - Country:US
Mailing Address - Phone:401-230-0217
Mailing Address - Fax:
Practice Address - Street 1:43 MAYFLOWER AVE
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-1913
Practice Address - Country:US
Practice Address - Phone:401-230-0217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist