MEDICARE: ARLENE C HAWKINS

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	104100000X	Social Worker	CSW001144	GA

General Provider Information

NPI Number	:	1922266725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARLENE C HAWKINS

Provider Business Mailing Address
First Line	:	2384 WINSHIRE DR
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30035-4215
Country	:	US
Telephone Number	:	770-981-3879
Fax Number	:	770-719-9738

Provider Business Practice Location Address
First Line	:	500 W LANIER AVE STE 904
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-7641
Country	:	US
Telephone Number	:	678-817-1120
Fax Number	:	770-719-9738

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

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	05/28/2008

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