Individual
MRS. AMY ELIZABETH SORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD CCC-SLP
Contact information
Practice address
2403 MARYLANE DR, ROGERS, AR 72756-6702
(479) 936-1381
Mailing address
2403 MARYLANE DR, ROGERS, AR 72756-6702
(479) 936-1381
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1646
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146974721
—
AR
01
—
99999
BLUE CROSS BLUE SHIELD
AR
01
—
999999999
RAILROAD MEDICARE
AR
Enumeration date
05/08/2007
Last updated
10/04/2010
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