Healthcare Provider Details

I. General information

NPI: 1588588578
Provider Name (Legal Business Name): TRICIA HAWKINS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 E 8TH ST
CAMBRIDGE OH
43725-2308
US

IV. Provider business mailing address

128 E 8TH ST
CAMBRIDGE OH
43725-2308
US

V. Phone/Fax

Practice location:
  • Phone: 740-439-3558
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number00207
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: