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Individual

MS. NATALIA INDRASARI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MFT

Contact information

Practice address
3408 WOODLAND AVE STE 102, WEST DES MOINES, IA 50266-6504
(515) 267-1996
(515) 207-9416
Mailing address
3775 EP TRUE PKWY # 152, WEST DES MOINES, IA 50265-7696
(515) 505-3507
(515) 207-9416

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0717001225
VA
106H00000X
Marriage & Family Therapist
Primary
086495
IA
106H00000X
Marriage & Family Therapist
175
HI

Other

Enumeration date
09/12/2011
Last updated
09/26/2018
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