Provider Demographics
NPI:1528652039
Name:HAWKINS, REBEKAH J
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:J
Last Name:HAWKINS
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 1:117 STROUPE RD UNIT C
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-8685
Mailing Address - Country:US
Mailing Address - Phone:704-772-6059
Mailing Address - Fax:
Practice Address - Street 1:117 STROUPE RD UNIT C
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-8685
Practice Address - Country:US
Practice Address - Phone:704-772-6059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000045019714103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst