Doctor Name: | MARY KATHLEEN SORENSON |
NPI Number: | 1023193398 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT/CHT |
License Number: | |
Business Practice Address: | 14300 Gallant Fox Ln Ste 114 Bowie, MD - 207154031 |
Business Phone Number: | 4102636638 |
Business Fax Number: | 4102686830 |
Mailing Address: | 14300 Gallant Fox Ln Ste 114, BOWIE |
State: | MD |
Postal Code: | 207154031 |
Phone Number: | 4102636638 |
Fax Number: | 4102686830 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251H1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Hand |
Taxonomy Definition: |