Individual
SAMANTHA MARIE SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D., LP
Contact information
Practice address
4601 EXCELSIOR BLVD STE 411, ST LOUIS PARK, MN 55416-4977
(763) 614-5060
(763) 614-5060
Mailing address
12331 MARMON ST NE, BLAINE, MN 55449-6280
(763) 350-9032
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP5556
MN
Other
Enumeration date
11/26/2012
Last updated
09/27/2021
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