Provider Information for 1578092813
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ALEXA SORENSEN CLSW
Sex: Female
NPI: 1578092813
Last Updated: 2022-12-01
Certification Date: 2022-12-01
Certification Date: 2022-12-01
Details
| Name | Value | ||||||||
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| NPI | 1578092813 | ||||||||
| Enumeration Date | 2017-06-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2789 N CEDARIDGE DR MIDLAND, MI 48642-8896 United States Phone: 313-330-3052 | Fax: | ||||||||
| Primary Practice Address | 4300 ESTATE DR HOLLAND, MI 49424-5608 United States Phone: 616-330-5566 | Fax: | ||||||||
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