Provider Demographics
NPI:1346954054
Name:MURRAY, SONJA (LAC, RN, CLC)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LAC, RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 BIRNAMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6812
Mailing Address - Country:US
Mailing Address - Phone:507-412-9739
Mailing Address - Fax:
Practice Address - Street 1:91 BIRNAMWOOD DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6812
Practice Address - Country:US
Practice Address - Phone:507-412-9739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2030171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist