Individual
MARK SORENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
30 LINCOLN ST, NEWTON, MA 02461-1527
(617) 965-6283
Mailing address
57 KENWOOD AVE, NEWTON, MA 02459-1421
(617) 332-5382
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3640
MA
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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