Provider Demographics
NPI:1194909671
Name:HAWKINS, SHANDOLYN G (MS,CCC,SLP)
Entity type:Individual
Prefix:MS
First Name:SHANDOLYN
Middle Name:G
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MS,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4177
Mailing Address - Street 2:650 PAGE ST., SUITE D
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-4177
Mailing Address - Country:US
Mailing Address - Phone:910-295-2609
Mailing Address - Fax:910-295-0026
Practice Address - Street 1:650 PAGE ST.
Practice Address - Street 2:SUITE D
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-4177
Practice Address - Country:US
Practice Address - Phone:910-295-2609
Practice Address - Fax:910-295-0026
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7906235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist