Provider Demographics
NPI:1528492436
Name:SOR BEL, ADRIANA (PSYD)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:SOR BEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARL R. DARNALL ARMY MEDICAL CENTER
Mailing Address - Street 2:36065 SANTA FE
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:657-235-4397
Mailing Address - Fax:
Practice Address - Street 1:36065 SANTA FE
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:76544-3081
Practice Address - Country:US
Practice Address - Phone:657-235-4397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 390200000X
WY642103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty