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Individual

ROYCE HAWKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
819 S SALINA ST, SYRACUSE, NY 13202-3527
(315) 476-7921
Mailing address
819 S SALINA ST, SYRACUSE, NY 13202-3527
(315) 476-7921
(315) 234-5987

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1610800039
COMMERCIAL
01
345276
MVP
Enumeration date
09/25/2008
Last updated
09/25/2008
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