Provider Demographics
NPI:1346082856
Name:HAWN, ALEXANDRIA JEAN
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:JEAN
Last Name:HAWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 PATTERSON ST SE
Mailing Address - Street 2:
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-1053
Mailing Address - Country:US
Mailing Address - Phone:712-331-4554
Mailing Address - Fax:
Practice Address - Street 1:1300 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2306
Practice Address - Country:US
Practice Address - Phone:515-280-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23070101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)