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General NPI Number Information
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NPI Number | 1255169736
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Entity Type | Individual
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Provider Name | ALASIA HAWKINS
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Gender | Female
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 495 WINN WAY
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City | DECATUR
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State | GA
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Zip | 30030-1736
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Country | US
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Telephone | 770-209-9826
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Fax |
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Provider Business Mailing Address
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Address Line | 905 CORNERS MILL DR # 905
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City | NORCROSS
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State | GA
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Zip | 30092-2781
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Country | US
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Telephone | 404-242-9381
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA003044
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License Number State | GA
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