Individual
BEAU SORRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
762 TRANSFER RD, SAINT PAUL, MN 55114-4506
(651) 900-2275
Mailing address
762 TRANSFER RD, SAINT PAUL, MN 55114-4506
(651) 900-2275
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16196
MN
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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