Doctor Name: | BRIAN S. POTTER |
NPI Number: | 1174775811 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | 3108 |
Business Practice Address: | 1211 Union Ave Suite 700 Memphis, TN - 381046638 |
Business Phone Number: | 9012875182 |
Business Fax Number: | 9012876700 |
Mailing Address: | 1211 Union Ave, Suite 700 MEMPHIS |
State: | TN |
Postal Code: | 381046638 |
Phone Number: | 9012875182 |
Fax Number: | 9012876700 |
NPI Enumeration Date: | 10/14/2008 |
NPI Last Update Date: | 11/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 3108 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |