Individual
GINA MARIE SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2222 TETON PLZ STE 2, IDAHO FALLS, ID 83404-6485
(208) 360-9654
Mailing address
2222 TETON PLZ STE 2, IDAHO FALLS, ID 83404-6485
(208) 360-9654
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31788
ID
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
About Stedi
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