Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003009465 |
---|---|
Provider Name | Pamela Sorrell |
First Address | Hazard, KY 41701-9415 |
Second Address | Hazard, KY 41701-9415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2007 |
Last Update Date | 20/08/2007 |