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Individual

HARLEY JASON HAWKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1108 RED MAPLE CT, LIBERTY, MO 64068-4357
(816) 519-1244
Mailing address
1108 RED MAPLE CT, LIBERTY, MO 64068-4357
(816) 519-1244

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2005038979
MO

Other

Enumeration date
10/03/2007
Last updated
10/03/2007
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