MEDICARE: ERIN MARGARET HAWKINS CCC-SLP

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	235Z00000X	Speech-Language Pathologist	LL 60174234	WA

General Provider Information

NPI Number	:	1841530011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN MARGARET HAWKINS CCC-SLP

Provider Business Mailing Address
First Line	:	1821 PLAZA WAY APT 45
Second Line	:
City	:	WALLA WALLA
State	:	WA
Zip	:	99362-4483
Country	:	US
Telephone Number	:	509-386-5553
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 SE MYRA RD
Second Line	:
City	:	COLLEGE PLACE
State	:	WA
Zip	:	99324-1796
Country	:	US
Telephone Number	:	509-386-5553
Fax Number	:

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

Provider Enumeration Date	:	02/25/2013
Last Update Date	:	02/25/2013

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