Healthcare Provider Details

I. General information

NPI: 1427535228
Provider Name (Legal Business Name): GABRIELLE HAWKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 INDIAN WOOD CIR STE 100
MAUMEE OH
43537-4029
US

IV. Provider business mailing address

219 E WASHINGTON ST
NAPOLEON OH
43545-1698
US

V. Phone/Fax

Practice location:
  • Phone: 419-491-0420
  • Fax: 567-698-7875
Mailing address:
  • Phone: 419-592-0540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1903675
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.1903675
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: