MEDICARE: DR. BLENDINE P HAWKINS PH. D., LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	531	HI

General Provider Information

NPI Number	:	1215449475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BLENDINE P HAWKINS PH. D., LMFT

Provider Business Mailing Address
First Line	:	921 HAUSTEN ST APT C5
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96826-3040
Country	:	US
Telephone Number	:	808-349-6649
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 KAPIOLANI BLVD STE 1340
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3806
Country	:	US
Telephone Number	:	808-349-6649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2017
Last Update Date	:	10/27/2017

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