Potter, Carol Gray
Potter, Carol Gray is an sole proprietor health care provider with primary practice located at 21 Candlewood Ln , Madison CT 06443-1914. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Gerontology, which is considered as her primary health care specialty. Potter, Carol Gray can be contacted via phone (425) 478-6098.Contact Information
Primary practice address
21 Candlewood Ln
Madison CT 06443-1914
Phone: (425) 478-6098
Fax: (425) 977-7193
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Gerontology | 225XG0600X | 6281 | Connecticut |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Gerontology | 225XG0600X | 1963 | Washington |
Profile Details
| NPI number | 1952304875 |
|---|---|
| LBN Legal business name | Potter, Carol Gray |
| Credentials | OTR/L, BCG |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2005 |
| Last updated | Sep 15th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952304875 | NPPES |
| Washington | Other | 0153392 | LABOR & INDUSTRIES |
| Washington | MEDICAID | 7682305 | LABOR & INDUSTRIES |
| Washington | Other | 0373PO | LABOR & INDUSTRIES |
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