| Master Potter Inc. | |
|
11302 Polaris Dr Upper Marlboro MD 20774-3539 | |
| (301) 675-6153 | |
| Not Available |
| Full Name | Master Potter Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11302 Polaris Dr, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Sylvana I Kwentua (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3016756153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Master Potter Inc. 11302 Polaris Dr Upper Marlboro MD 20774 Ph: (301) 675-6153 | Master Potter Inc. 11302 Polaris Dr Upper Marlboro MD 20774-3539 Ph: (301) 675-6153 |
| NPI Number | 1184999724 |
|---|---|
| Provider Enumeration Date | 03/15/2012 |
| Last Update Date | 03/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184999724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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