Provider Demographics
NPI:1699761577
Name:HAWK, BARABARA ANN (RPT)
Entity type:Individual
Prefix:MRS
First Name:BARABARA
Middle Name:ANN
Last Name:HAWK
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:643 NAKOTA DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-5730
Mailing Address - Country:US
Mailing Address - Phone:937-878-4433
Mailing Address - Fax:
Practice Address - Street 1:4881 SUGAR MAPLE DR
Practice Address - Street 2:88MDG/SGCP
Practice Address - City:WRIGHT PATTERSON AFB
Practice Address - State:OH
Practice Address - Zip Code:45433-5546
Practice Address - Country:US
Practice Address - Phone:937-257-8753
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist