Provider Demographics
NPI:1699450312
Name:BROOKS-HAWKINS, MIEKA
Entity type:Individual
Prefix:
First Name:MIEKA
Middle Name:
Last Name:BROOKS-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 1:2210 TALL PINES DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-5347
Mailing Address - Country:US
Mailing Address - Phone:941-822-4860
Mailing Address - Fax:
Practice Address - Street 1:2210 TALL PINES DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-5347
Practice Address - Country:US
Practice Address - Phone:941-822-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health