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Individual

CHARLEY MARISSA HAWKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
407 CARSON ST, HOT SPRINGS, AR 71901-6852
(501) 620-6619
(501) 624-1176
Mailing address
PO BOX 2440, HOT SPRINGS, AR 71914-2440
(501) 620-6619

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-76649
AR
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274145706
AR
Enumeration date
04/27/2020
Last updated
11/01/2024
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