Provider Demographics
NPI:1366330276
Name:POTTER TEEHAN, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:POTTER TEEHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13404 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:WAKEMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44889-9025
Mailing Address - Country:US
Mailing Address - Phone:440-865-0969
Mailing Address - Fax:
Practice Address - Street 1:13404 BUTLER RD
Practice Address - Street 2:
Practice Address - City:WAKEMAN
Practice Address - State:OH
Practice Address - Zip Code:44889-9025
Practice Address - Country:US
Practice Address - Phone:440-865-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach