MEDICARE: SONJA LYNN KAREEM WALKER LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	3844	MN

General Provider Information

NPI Number	:	1003568189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONJA LYNN KAREEM WALKER LMFT

Provider Business Mailing Address
First Line	:	4930 JACKSON AVE
Second Line	:
City	:	WEBSTER
State	:	MN
Zip	:	55088-2024
Country	:	US
Telephone Number	:	612-800-2811
Fax Number	:

Provider Business Practice Location Address
First Line	:	4930 JACKSON AVE
Second Line	:
City	:	WEBSTER
State	:	MN
Zip	:	55088-2024
Country	:	US
Telephone Number	:	612-800-2811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2022
Last Update Date	:	01/20/2022

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