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General NPI Number Information
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NPI Number | 1366900912
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Entity Type | Individual
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Provider Name | LATANYA HAWKINS
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Gender | Female
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Dates
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Enumeration Date | 03/03/2019
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 2751 WOODDALE BLVD STE A
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City | BATON ROUGE
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State | LA
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Zip | 70805-7567
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Country | US
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Telephone | 225-925-1906
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Fax |
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Provider Business Mailing Address
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Address Line | 104 STONEHURST DR APT 5A
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City | NATCHEZ
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State | MS
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Zip | 39120-4239
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Country | US
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Telephone | 601-443-8116
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PLC-8036
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License Number State | LA
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