Healthcare Provider Details

I. General information

NPI: 1083357073
Provider Name (Legal Business Name): SONIA ABRIL TORREY LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 CRESTHAVEN RD
MEMPHIS TN
38119-3833
US

IV. Provider business mailing address

4945 HAMPSHIRE AVE
MEMPHIS TN
38117-5630
US

V. Phone/Fax

Practice location:
  • Phone: 901-604-0305
  • Fax:
Mailing address:
  • Phone: 901-604-0305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4939
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: