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Individual

DR. SHEILA MARIE POTTEBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
939 OFFICE PARK RD, SUITE 200, WEST DES MOINES, IA 50265-2505
(515) 226-2508
(515) 440-3388
Mailing address
939 OFFICE PARK RD, SUITE 200, WEST DES MOINES, IA 50265-2505
(515) 226-2508
(515) 440-3388

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
638
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014316
IA
01
01431
WELLMARK BLUE CROSS
IA
01
18669
MIDLANDS CHOICE
IA
01
42105384450265A015
TRIWEST
IA
Enumeration date
07/13/2006
Last updated
07/08/2007
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