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General NPI Number Information
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NPI Number | 1770311151
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Entity Type | Individual
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Provider Name | MEGGAN HAWKE
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Gender | Female
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 1291 EXPRESSWAY LN
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City | SPANISH FORK
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State | UT
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Zip | 84660-1333
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Country | US
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Telephone | 801-367-0394
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Fax |
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Provider Business Mailing Address
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Address Line | 644 N 200 E
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City | NEPHI
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State | UT
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Zip | 84648-1213
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Country | US
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Telephone | 435-660-9493
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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 | 14039425-6006
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License Number State | UT
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