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General NPI Number Information
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NPI Number | 1255197349
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Entity Type | Individual
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Provider Name | MIA HAWBAKER
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Gender | Female
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 5625 STRAND BLVD STE 512
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City | NAPLES
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State | FL
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Zip | 34110-7384
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Country | US
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Telephone | 239-392-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 19512 THE PLACE BLVD
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City | ESTERO
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State | FL
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Zip | 33928-6624
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Country | US
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Telephone |
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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