Provider Demographics
NPI:1386808731
Name:HAWKINS, DEANA LYNNE (MSOTR/L)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:LYNNE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:DEANA
Other - Middle Name:LYNNE
Other - Last Name:HOSTETTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTR/L
Mailing Address - Street 1:1118 COUNTY ROAD 2100 E
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62837-3124
Mailing Address - Country:US
Mailing Address - Phone:618-517-4435
Mailing Address - Fax:
Practice Address - Street 1:1118 COUNTY ROAD 2100 E
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IL
Practice Address - Zip Code:62837-3124
Practice Address - Country:US
Practice Address - Phone:618-517-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017026969225X00000X
IL056008112225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist