Provider Demographics
NPI:1275300873
Name:SQUIERS, SONJA (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:SQUIERS
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 COLLEGE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT BONIFACIUS
Mailing Address - State:MN
Mailing Address - Zip Code:55375-9002
Mailing Address - Country:US
Mailing Address - Phone:763-221-7354
Mailing Address - Fax:
Practice Address - Street 1:8700 COLLEGE VIEW DR
Practice Address - Street 2:
Practice Address - City:SAINT BONIFACIUS
Practice Address - State:MN
Practice Address - Zip Code:55375-9001
Practice Address - Country:US
Practice Address - Phone:763-221-7354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN38102255A2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer