Provider Demographics
NPI:1356948632
Name:SORBARA, ALEXIS (MA, LMFT-A, ATR-P)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:SORBARA
Suffix:
Gender:F
Credentials:MA, LMFT-A, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 S MONTREAL AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-5643
Mailing Address - Country:US
Mailing Address - Phone:203-912-1023
Mailing Address - Fax:
Practice Address - Street 1:9330 LYNDON B JOHNSON FWY STE 1250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3436
Practice Address - Country:US
Practice Address - Phone:972-841-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19-479221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist