Provider Demographics
NPI:1124465851
Name:HAWKINS, REBECCA LYNN (DPT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12319 HIGHLAND RD STE 501
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48353-2946
Mailing Address - Country:US
Mailing Address - Phone:810-991-1211
Mailing Address - Fax:810-991-1656
Practice Address - Street 1:12319 HIGHLAND RD STE 501
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2946
Practice Address - Country:US
Practice Address - Phone:810-991-1211
Practice Address - Fax:810-991-1656
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist