Healthcare Provider Details

I. General information

NPI: 1104594530
Provider Name (Legal Business Name): MARIA LOUISE HAWN PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 WOODSTONE DR
SAINT CHARLES MO
63304-6869
US

IV. Provider business mailing address

6 GREENBRIAR CT
SAINT CHARLES MO
63301-0736
US

V. Phone/Fax

Practice location:
  • Phone: 636-492-5022
  • Fax:
Mailing address:
  • Phone: 636-795-3508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2021034904
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: