# DIANNA SORENSEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1225619851
- **Gender:** F
- **Credential:** L.D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | 110067 | KY | Yes |

## Other

- **Enumeration date:** 04/15/2021
- **Last updated:** 04/15/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1003908849 | — | KY |