| NPI | 1003253550 |
|---|---|
| Former Name | AMANDA NICOLE SORRELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 01046) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2018-10-18 |