Individual
SONNY JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4140 RICHARD AVE, HERMANTOWN, MN 55811-2869
(507) 353-2536
Mailing address
4140 RICHARD AVE STE 200&300, HERMANTOWN, MN 55811-2869
(218) 514-5230
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0440
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588993091
—
MN
Enumeration date
11/09/2020
Last updated
10/16/2025
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