Individual
MISS AMY R SORRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
1505 DOCTORS DR, BOSSIER CITY, LA 71111-3321
(318) 400-5519
Mailing address
1505 DOCTORS DR, BOSSIER CITY, LA 71111-3321
(318) 400-5519
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/30/2022
Last updated
02/07/2023
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