Individual
LARRIELLE Y HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 MALL CT UNIT A, SAVANNAH, GA 31406-3666
(912) 349-4843
Mailing address
41 PACELLA PARK DR, RANDOLPH, MA 02368-1755
(781) 437-0791
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-20-44910
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
10/26/2017
Last updated
10/21/2020
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