Provider Demographics
NPI:1972966497
Name:SORRICK, DAVID DUANE (MASTER OF SCIENCE, L)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:DUANE
Last Name:SORRICK
Suffix:
Gender:M
Credentials:MASTER OF SCIENCE, L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 NORTH AMIDON
Mailing Address - Street 2:SUITE 232
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203
Mailing Address - Country:US
Mailing Address - Phone:620-213-1110
Mailing Address - Fax:
Practice Address - Street 1:1999 NORTH AMIDON
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203
Practice Address - Country:US
Practice Address - Phone:620-213-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS186106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist