Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | UT |
NPI | 1003821794 |
---|---|
Provider Name | Dorothy Sorenson |
First Address | Farmington, UT 84025-0689 |
Second Address | Clearfield, UT 84015-1630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 08/07/2007 |