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General NPI Number Information
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NPI Number | 1598319279
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Entity Type | Individual
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Provider Name | SONYA PRATER LMT
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Gender | Female
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 3070 WINDWARD PLZ STE X2
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City | ALPHARETTA
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State | GA
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Zip | 30005-8773
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Country | US
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Telephone | 843-540-0019
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Fax |
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Provider Business Mailing Address
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Address Line | 100 ASHLEY GLN
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City | CANTON
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State | GA
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Zip | 30115-6316
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Country | US
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Telephone | 843-540-0019
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH010926
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT014480
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License Number State | GA
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