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General NPI Number Information
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NPI Number | 1770215485
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Entity Type | Organization
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Legal Business Name | CAMILLE HAWKINS, LLC
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 12587 S FORT ST
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City | DRAPER
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State | UT
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Zip | 84020-9382
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Country | US
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Telephone | 801-203-0244
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Fax |
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Provider Business Mailing Address
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Address Line | 418 E 8800 S
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City | SANDY
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State | UT
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Zip | 84070-1760
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Country | US
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Telephone | 801-203-0244
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | CAMILLE HAWKINS
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Credential | LCSW
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Telephone | 801-203-0244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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