Individual
JACQUELINE T SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
601 W MICHIGAN ST, ORLANDO, FL 32805-6203
(407) 317-7430
(407) 648-4150
Mailing address
601 W MICHIGAN ST, ORLANDO, FL 32805-6203
(407) 317-7430
(407) 648-4150
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS 000387
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SS 000387
FL LICENSE
FL
Enumeration date
01/11/2012
Last updated
01/11/2012
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