Provider Demographics
NPI:1144478157
Name:TRUE POTENTIAL PLLC
Entity type:Organization
Organization Name:TRUE POTENTIAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:915-887-8753
Mailing Address - Street 1:2193 N CAMINO PRINCIPAL
Mailing Address - Street 2:STE 145
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5336
Mailing Address - Country:US
Mailing Address - Phone:915-887-8753
Mailing Address - Fax:520-396-3785
Practice Address - Street 1:2193 N CAMINO PRINCIPAL
Practice Address - Street 2:STE 145
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5336
Practice Address - Country:US
Practice Address - Phone:915-887-8753
Practice Address - Fax:520-396-3785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty