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General NPI Number Information
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NPI Number | 1871069138
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Entity Type | Individual
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Provider Name | KAITLYN L SORENSEN AUD
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Gender | Female
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 55 S RACEWAY RD STE 900
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City | INDIANAPOLIS
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State | IN
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Zip | 46231-1064
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Country | US
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Telephone | 317-973-7109
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Fax |
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Provider Business Mailing Address
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Address Line | 6659 WHITESTOWN PKWY
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City | ZIONSVILLE
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State | IN
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Zip | 46077-7622
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Country | US
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Telephone | 317-973-7109
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 23002666A
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License Number State | IN
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