Individual
INDRASARI MACKENZIE MURSID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8340 MISSION RD STE 230, PRAIRIE VILLAGE, KS 66206-1319
(913) 735-0577
Mailing address
9200 E 87TH ST, RAYTOWN, MO 64138-4511
(651) 895-9555
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
04040
KS
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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