Provider Demographics
NPI:1366643934
Name:RAY, SONJA SUNNY (CCN, LN, CTN)
Entity Type:Individual
Prefix:DR
First Name:SONJA
Middle Name:SUNNY
Last Name:RAY
Suffix:
Gender:F
Credentials:CCN, LN, CTN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 SADDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-2656
Mailing Address - Country:US
Mailing Address - Phone:952-936-9029
Mailing Address - Fax:952-936-9132
Practice Address - Street 1:4509 SADDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-2656
Practice Address - Country:US
Practice Address - Phone:952-936-9029
Practice Address - Fax:952-936-9132
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FMN147133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist