Provider Demographics
NPI:1114337961
Name:CASSANDRA SORENSEN
Entity Type:Organization
Organization Name:CASSANDRA SORENSEN
Other - Org Name:RUMINA LACTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD CERTIFIED LACTATION CONSULTAN
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:214-226-7549
Mailing Address - Street 1:3001 MAPLELAWN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723
Mailing Address - Country:US
Mailing Address - Phone:214-226-7549
Mailing Address - Fax:
Practice Address - Street 1:3001 MAPLELAWN CIRCLE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723
Practice Address - Country:US
Practice Address - Phone:214-226-7549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33250963251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health