Most Relevant Information
Provider Data
| NPI Number: | 1003424003 |
| Provider Name: | SALLY SOROUR |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/16/2020 |
| Last Updated: | 04/10/2024 |
Provider Practice Location
1811 GRAND CANAL BLVD STE 2
STOCKTON
CA
952078107
Practice Location Phone/Fax
| Phone: | 8888809270 |
| Fax: |
Provider Mailing Location
350 FAIRWAY DR STE 101
DEERFIELD BEACH
FL
334411834
Provider Mailing Phone/Fax
| Phone: | 8774182978 |
| Fax: |