Provider Demographics
NPI:1316191265
Name:HAWKINS, SANDRA LYNN (MED, MS)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LYNN
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MED, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5927
Mailing Address - Country:US
Mailing Address - Phone:518-209-3440
Mailing Address - Fax:
Practice Address - Street 1:4 MICHAEL DR
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5927
Practice Address - Country:US
Practice Address - Phone:518-209-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012385-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist