Doctor Name: | MR. AMMON SORENSEN |
NPI Number: | 1265738785 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APC |
License Number: | 8149517-6009 |
Business Practice Address: | 198 E Center St Moab, UT - 845322430 |
Business Phone Number: | 4352596131 |
Business Fax Number: | 4352595369 |
Mailing Address: | 198 E Center St, MOAB |
State: | UT |
Postal Code: | 845322430 |
Phone Number: | 4352596131 |
Fax Number: | 4352595369 |
NPI Enumeration Date: | 01/31/2011 |
NPI Last Update Date: | 01/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 8149517-6009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |