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General NPI Number Information
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NPI Number | 1407356744
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Entity Type | Individual
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Provider Name | JESSICA HAWK
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Gender | Female
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 5655 N HIGH ST
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City | WORTHINGTON
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State | OH
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Zip | 43085-3948
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Country | US
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Telephone | 614-885-0920
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Fax |
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Provider Business Mailing Address
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Address Line | 5273 REDMOND CT
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City | HILLIARD
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State | OH
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Zip | 43026-8848
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Country | US
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Telephone | 614-315-6312
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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