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General NPI Number Information
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NPI Number | 1346082856
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Entity Type | Individual
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Provider Name | ALEXANDRIA JEAN HAWN
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Gender | Female
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 1300 WOODLAND AVE
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2306
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Country | US
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Telephone | 515-280-3860
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Fax |
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Provider Business Mailing Address
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Address Line | 132 PATTERSON ST SE
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City | BONDURANT
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State | IA
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Zip | 50035-1053
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Country | US
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Telephone | 712-331-4554
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 23070
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License Number State | IA
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