| Doctor Name: | MRS. DEIDRA ALEXANDER SORRELL |
| NPI Number: | 1063538791 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PRC13819 |
| Business Practice Address: | 1282 Smallwood Dr W Ste #250 Waldorf, MD - 206034732 |
| Business Phone Number: | 2404611305 |
| Business Fax Number: | |
| Mailing Address: | 1282 Smallwood Dr W, Ste #250 WALDORF |
| State: | MD |
| Postal Code: | 206034732 |
| Phone Number: | 2404611305 |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 10/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PRC13819 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |