=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336698463
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADELE HAWLEY PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2016
-----------------------------------------------------
Last Update Date | 09/30/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2315 HANOVER PIKE STE G
-----------------------------------------------------
City | HAMPSTEAD
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21074-1136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-374-0925
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 501 FAIRMOUNT AVE SUITE 302
-----------------------------------------------------
City | TOWSON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21286-5457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-927-8768
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------