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General NPI Number Information
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NPI Number | 1487248274
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Entity Type | Individual
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Provider Name | KIMBERLYN RACHAEL SORVAAG MSW, APSW
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Gender | Female
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 3703 OAKWOOD HILLS PKWY STE 100
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4458
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Country | US
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Telephone | 219-241-6422
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 SILVER LAKE RD NW STE 110
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City | NEW BRIGHTON
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State | MN
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Zip | 55112-1789
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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