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General NPI Number Information
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NPI Number | 1437182243
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Entity Type | Individual
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Provider Name | SOREN JAMES BARRETT PH.D
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 3625 EAGLE DR
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City | VERO BEACH
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State | FL
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Zip | 32963-1650
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Country | US
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Telephone | 772-538-1038
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 644114
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City | VERO BEACH
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State | FL
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Zip | 32964-4114
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Country | US
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Telephone | 772-538-1038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY4688
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License Number State | FL
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