Healthcare Provider Details

I. General information

NPI: 1356948632
Provider Name (Legal Business Name): ALEXIS SORBARA MA, LMFT-A, ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 LYNDON B JOHNSON FWY STE 1250
DALLAS TX
75243-3436
US

IV. Provider business mailing address

323 S MONTREAL AVE
DALLAS TX
75208-5643
US

V. Phone/Fax

Practice location:
  • Phone: 972-841-7131
  • Fax:
Mailing address:
  • Phone: 203-912-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number19-479
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: