MEDICARE: MS. CAROL M HAWKINS 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	200928	TX

General Provider Information

NPI Number	:	1841426673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL M HAWKINS LMFT

Provider Business Mailing Address
First Line	:	1844 LOCKHILL SELMA RD
Second Line	:	101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1503
Country	:	US
Telephone Number	:	210-377-1133
Fax Number	:	210-377-1230

Provider Business Practice Location Address
First Line	:	1844 LOCKHILL SELMA RD
Second Line	:	101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1503
Country	:	US
Telephone Number	:	210-377-1133
Fax Number	:	210-377-1230

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

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	06/08/2009

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