Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 23263 | TX |
N | 103TC0700X | Clinical Psychologist | 23263 | TX |
Y | 102L00000X | Psychologist | 23263 | TX |
Y | 103T00000X | Psychologist | 23263 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 23263 | TX |
N | 103G00000X | Clinical Psychologist | 23263 | TX |
N | 103TC0700X | Clinical Psychologist | 23263 | TX |
N | 103TC1900X | Counseling Psychologist | 23263 | TX |
N | 103TF0200X | Forensic Psychologist | 23263 | TX |
N | 103TH0004X | Health Psychologist | 23263 | TX |
NPI | 1184802308 |
---|---|
Provider Name | Dr. Melody Milam Potter |
First Address | Weatherford, TX 76088-8729 |
Second Address | Weatherford, TX 76088-8729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2008 |
Last Update Date | 11/02/2008 |