Healthcare Provider Details

I. General information

NPI: 1568301802
Provider Name (Legal Business Name): SONIA FAITH HAMMILL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 BUCHANAN ST N STE 150
CAMBRIDGE MN
55008-1640
US

IV. Provider business mailing address

808 11TH AVE NE
MILACA MN
56353-2110
US

V. Phone/Fax

Practice location:
  • Phone: 763-552-7703
  • Fax:
Mailing address:
  • Phone: 320-360-0639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number103019
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: