MEDICARE: ADRIANA SOR BEL PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	390200000X	Student in an Organized Health Care Education/Training Program
3	103TC0700X	Clinical Psychologist	642	WY

General Provider Information

NPI Number	:	1528492436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA SOR BEL PSYD

Provider Business Mailing Address
First Line	:	CARL R. DARNALL ARMY MEDICAL CENTER
Second Line	:	36065 SANTA FE
City	:	APO
State	:	AA
Zip	:	76544
Country	:	US
Telephone Number	:	657-235-4397
Fax Number	:

Provider Business Practice Location Address
First Line	:	36065 SANTA FE
Second Line	:
City	:	APO
State	:	AA
Zip	:	76544-3081
Country	:	US
Telephone Number	:	657-235-4397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	06/14/2018

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