Provider Demographics
NPI:1740690650
Name:SORENSEN, CASSANDRA (IBCLC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 MAPLELAWN CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3727
Mailing Address - Country:US
Mailing Address - Phone:214-226-7549
Mailing Address - Fax:
Practice Address - Street 1:3001 MAPLELAWN CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3727
Practice Address - Country:US
Practice Address - Phone:214-226-7549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN